Tetrazolones as inhibitors of fatty acid synthase

ABSTRACT

Provided herein are tetrazolone FASN inhibitors of the formula (I): 
                         
or a pharmaceutically acceptable form thereof; wherein the variables R A , R B  and R C  are defined herein.
 
     Also provided herein are pharmaceutical compositions of the compounds provided herein as well as methods of their use for the treatment of various disorders such as hyperproliferative disorders, inflammatory disorders, obesity-related disorders and microbial infections.

This application claims priority to U.S. Provisional Application Nos. 61/331,575, filed May 5, 2010; 61/331,644, filed May 5, 2010; 61/419,174, filed Dec. 2, 2010; 61/437,564, filed Jan. 28, 2011; and 61/472,566, filed Apr. 6, 2011. The contents of U.S. Provisional Application Nos. 61/331,575, filed May 5, 2010; 61/331,644, filed May 5, 2010; 61/437,564, filed Jan. 28, 2011; and 61/472,566, filed Apr. 6, 2011 are incorporated herein in their entireties.

A text file of sequence listing (SEQLIST 12928-033-999.TXT; created May 4, 2011; size 20,000 bytes), filed electronically, is incorporated herein by reference.

BACKGROUND

Fatty acid synthase (FASN) is a key enzyme for the synthesis of long-chain fatty acids from acetyl-coenzyme A (CoA) and malonyl-CoA that uses reduced nicotinamide adenine dinucleotidephosphate as a cofactor. FASN is minimally expressed in most normal human tissues except the liver and adipose tissue, where it is expressed at high levels. Since FASN expression is markedly increased in several human cancers compared with the corresponding normal tissue, and FASN overexpression in tumors has been associated with a poor prognosis, FASN inhibitors have long been viewed as potential therapeutics for the treatment of cancer. FASN inhibitors have also shown promise in the treatment of other FASN-mediated diseases, disorders or conditions, such as obesity, lack of appetite control and inflammatory conditions.

Furthermore, FASN has been identified as a target for treatment of microbial infections. In particular, it was reported that fatty acid synthesis or the level of fatty acid is critical in viral pathogenesis. For example, it was reported that the formation of a novel vesicular compartment (i.e., remodelled golgi apparatus), on the surface of which viral RNA replication takes place, requires fatty acid biosynthesis. (See Cherry et al., PLoS Pathogens, 2(10): e102 (2006)). In addition, fatty acid biosynthesis has been indentified as a target for anti-viral therapy using a metabolic profiling of the hosts upon viral infection. (See Munger et al., Nature Biotechnology, 26: 1179-1186 (2008). It was also reported that inhibition of fatty acid biosynthesis (e.g., inhibition of fatty acid synthase) results in reduced replication of human cytomegalomous virus (HCMV) and influenza A viruses. (Id.).

Reports establishing FASN as a valid target for the treatment of viral infections are available for various viruses. For example, the role of FASN has been implicated in the pathogenesis of an enveloped virus such as human cytomegalomous virus (HCMV), influenza A and Hepatitis C (HCV). (See Munger et al., Nature Biotechnology, 26: 1179-1186 (2008); Syed et al., Trends in Endocrinology and Metabolism, 21: 33-40 (2009); Sakamoto et al., Nature Chemical Biology, 1: 333-337 (2005); Yang et al., Hepatology, 48: 1396-1403 (2008)). With regard to HCV, it was reported that an elevated level of fatty acid biosynthesis enzymes, including FASN, contributes to liver steatosis, leading to cirrhosis and hepatocellular carcinoma, upon HCV infection. (Fukusawa et al., Biol. Pharm. Bull., 29(9): 1958-1961 (2006)). HCV replication was reported to be regulated by, among others, fatty acid biosynthesis. (Kapadia et al., Proc. Natl. Acad. Sci., 102(7): 2561-2566 (2005)). Other reports establishing FASN as a potential host-target against HCV have also been published. (See, e.g., Hepatology, 48: 1396 (2008); Trends Endocrine Metabol., 21: 33 (2010); and Virology, 394: 130 (2009)).

With regard to other various viruses, it was reported that the FASN expression is increased in the cells infected by coxsackievirus B3 (CVB3), a picornavirus, and the replication of CVB3 is blocked by FASN inhibitors. (See Rassmann et al., Antiviral Research, 76: 150-158 (2007)). FASN was reported to be important in lytic viral replication of Epstein-Barr virus (EBV), and it was suggested that FASN inhibition may be a novel approach for blocking the EBV replication. (Li et al., Journal of Virology, 78(8): 4197-4206 (2004)). The role of FASN in the replication of dengue virus has also been implicated. (See, e.g., Heaton et al., Proc. Natl. Acad. Sci., 107(40): 17345-17350 (2010); and Samsa et al., PLoS Pathegens, 5(10): e1000632 (2009)). Moreover, aside from being a potential target for anti-viral therapy, the role of FASN has also been implicated in diabetes or regulation of the general wellness of the liver. (See, e.g., Wu et al., PNAS Early Edition, www.pnas.org/cgi/doi/10.1073/pnas.1002588108 (2011)). Thus, there is a need for effective inhibitors of FASN, which can be potentially used as therapies for microbial infections, including, but not limited to viral infections, or other diseases and disorders.

SUMMARY

Provided herein are tetrazolone FASN inhibitors of the formula (I):

or a pharmaceutically acceptable form thereof; wherein the variables R^(A), R^(B) and R^(C) are defined below and herein.

Also provided herein are pharmaceutical compositions comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof. Also provided herein are methods of treating cancer comprising administering at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition thereof, to a subject in need thereof. Also provided herein are methods of treating microbial infections comprising administering at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition thereof, to a subject in need thereof.

The details of additional or alternative embodiments are set forth in the accompanying Detailed Description and Exemplification as described below. Other features, objects, and advantages will be apparent from this description and from the claims.

SEQUENCE IDENTIFICATION NUMBERS

SEQ ID NO. 1: Homo sapiens FASN amino acid sequence: MEEVVIAGMSGKLPESENLQEFWDNLIGGVDMVTDDDRRWKAGLYGLPRR SGKLKDLSRFDASFFGVHPKQAHTMDPQLRLLLEVTYEAIVDGGINPDSL RGTHTGVWVGVSGSETSEALSRDPETLVGYSMVGCQRAMMANRLSFFFDF RGPSIALDTACSSSLMALQNAYQAIHSGQCPAAIVGGINVLLKPNTSVQF LRLGMLSPEGTCKAFDTAGNGYCRSEGVVAVLLTKKSLARRVYATILNAG TNTDGFKEQGVTFPSGDIQEQLIRSLYQSAGVAPESFEYIEAHGTGTKVG DPQELNGITRALCATRQEPLLIGSTKSNMGHPEPASGLAALAKVLLSLEH GLWAPNLHFHSPNPEIPALLDGRLQVVDQPLPVRGGNVGINSFGFGGSNV HIILRPNTQPPPAPAPHATLPRLLRASGRTPEAVQKLLEQGLRHSQDLAF LSMLNDIAAVPATAMPFRGYAVLGGERGGPEVQQVPAGERPLWFICSGMG TQWRGMGLSLMRLDRFRDSILRSDEAVKPFGLKVSQLLLSTDESTFDDIV HSFVSLTAIQIGLIDLLSCMGLRPDGIVGHSLGEVACGYADGCLSQEEAV LAAYWRGQCIKEAHLPPGAMAAVGLSWEECKQRCPPGVVPACHNSKDTVT ISGPQAPVFEFVEQLRKEGVFAKEVRTGGMAFHSYFMEAIAPPLLQELKK VIREPKPRSARWLSTSIPEAQWHSSLARTSSAEYNVNNLVSPVLFQEALW HVPEHAVVLEIAPHALLQAVLKRGLKPSCTIIPLMKKDHRDNLEFFLAGI GRLHLSGIDANPNALFPPVEFPAPRGTPLISPLIKWDHSLAWDVPAAEDF PNGSGSPSAAIYNIDTSSESPDHYLVDHTLDGRVLFPATGYLSIVWKTLA RALGLGVEQLPVVFEDVVLHQATILPKTGTVSLEVRLLEASRAFEVSENG NLVVSGKVYQWDDPDPRLFDHPESPTPNPTEPLFLAQAEVYKELRLRGYD YGPHFQGILEASLEGDSGRLLWKDNWVSFMDTMLQMSILGSAKHGLYLPT RVTAIHIDPATHRQKLYTLQDKAQVADVVVSRWLRVTVAGGVHISGLHTE SAPRRQQEQQVPILEKFCFTPHTEEGCLSERAALQEELQLCKGLVQALQT KVTQQGLKMVVPGLDGAQIPRDPSQQELPRLLSAACRLQLNGNLQLELAQ VLAQERPKLPEDPLLSGLLDSPALKACLDTAVENMPSLKMKVVEVLAGHG HLYSRIPGLLSPHPLLQLSYTATDRHPQALEAAQAELQQHDVAQGQWDPA DPAPSALGSADLLVCNCAVAALGDPASALSNMVAALREGGFLLLHTLLRG HPLGDIVAFLTSTEPQYGQGILSQDAWESLFSRVSLRLVGLKKSFYGSTL FLCRRPTPQDSPIFLPVDDTSFRWVESLKGILADEDSSRPVWLKAINCAT SGVVGLVNCLRREPGGNRLRCVLLSNLSSTSHVPEVDPGSAELQKVLQGD LVMNVYRDGAWGAFRHFLLEEDKPEEPTAHAFVSTLTRGDLSSIRWVCSS LRHAQPTCPGAQLCTVYYASLNFRDIMLATGKLSPDAIPGKWTSQDSLLG MEFSGRDASGKRVMGLVPAKGLATSVLLSPDFLWDVPSNWTLEEAASVPV VYSTAYYALVVRGRVRPGETLLIHSGSGGVGQAAIAIALSLGCRVFTTVG SAEKRAYLQARFPQLDSTSFANSRDTSFEQHVLWHTGGKGVDLVLNSLAE EKLQASVRCLATHGRFLEIGKFDLSQNHPLGMAIFLKNVTFHGVLLDAFF NESSADWREVWALVQAGIRDGVVRPLKCTVFHGAQVEDAFRYMAQGKHIG KVVVQVLAEEPEAVLKGAKPKLMSAISKTFCPAHKSYIIAGGLGGFGLEL AQWLIQRGVQKLVLTSRSGIRTGYQAKQVRRWRRQGVQVQVSTSNISSLE GARGLIAEAAQLGPVGGVFNLAVVLRDGLLENQTPEFFQDVCKPKYSGTL NLDRVTREACPELDYFVVFSSVSCGRGNAGQSNYGFANSAMERICEKRRH EGLPGLAVQWGAIGDVGILVETMSTNDTIVSGTLPQRMASCLEVLDLFLN QPHMVLSSFVLAEKAAAYRDRDSQRDLVEAVAHILGIRDLAAVNLDSSLA DLGLDSLMSVEVRQTLERELNLVLSVREVRQLTLRKLQELSSKADEASEL ACPTPKEDGLAQQQTQLNLRSLLVNPEGPTLMRLNSVQSSERPLFLVHPI EGSTTVFHSLASRLSIPTYGLQCTRAAPLDSIHSLAAYYIDCIRQVQPEG PYRVAGYSYGACVAFEMCSQLQAQQSPAPTHNSLFLFDGSPTYVLAYTQS YRAKLTPGCEAEAETEAICFFVQQFTDMEHNRVLEALLPLKGLEERVAAA VDLIIKSHQGLDRQELSFAARSFYYKLRAAEQYTPKAKYHGNVMLLRAKT GGAYGEDLGADYNLSQVCDGKVSVHVIEGDHRTLLEGSGLESIISIIHSS LAEPRVSVREG

DEFINITIONS

Definitions of specific functional groups and chemical terms are described in more detail below. The chemical elements are identified in accordance with the Periodic Table of the Elements, CAS version, Handbook of Chemistry and Physics, 75^(th) Ed., inside cover, and specific functional groups are generally defined as described therein. Additionally, general principles of organic chemistry, as well as specific functional moieties and reactivity, are described in Organic Chemistry, Thomas Sorrell, University Science Books, Sausalito, 1999; Smith and March March's Advanced Organic Chemistry, 5^(th) Edition, John Wiley & Sons, Inc., New York, 2001; Larock, Comprehensive Organic Transformations, VCH Publishers, Inc., New York, 1989; and Carruthers, Some Modern Methods of Organic Synthesis, 3^(rd) Edition, Cambridge University Press, Cambridge, 1987.

Certain compounds provided herein can comprise one or more asymmetric centers, and thus can exist in various isomeric forms, e.g., enantiomers and/or diastereomers and/or stereoisomers. The compounds provided herein can be in the form of an individual enantiomer, diastereomer or geometric isomer, or can be in the form of a mixture of stereoisomers, including racemic mixtures and mixtures enriched in one or more stereoisomer. In certain embodiments, the compounds provided herein are enantiopure compounds. In certain other embodiments, mixtures of stereoisomers are provided.

Furthermore, certain compounds, as described herein can have one or more double bonds that can exist as either the cis or trans, or the E or Z isomer, unless otherwise indicated. Also encompassed are the compounds as individual isomers substantially free of other isomers, and alternatively, as mixtures of various isomers, e.g., racemic mixtures of E/Z isomers or mixtures enriched in one E/Z isomer.

The terms “optically enriched”, “enantiomerically enriched,” “enantiomerically pure” and “non-racemic,” as used interchangeably herein, refer to compositions in which the percent by weight of one enantiomer is greater than the amount of that one enantiomer in a control mixture of the racemic composition (e.g., greater than 1:1 by weight). In addition, the term “non-racemic” can apply more broadly to mixtures of stereoisomers, diastereomers or olefin E/Z isomers. For example, an enantiomerically enriched preparation of the (S)-enantiomer, means a preparation of the compound having greater than 50% by weight of the (S)-enantiomer relative to the (R)-enantiomer, such as at least 75% by weight, and even such as at least 80% by weight. In some embodiments, the enrichment can be much greater than 80% by weight, providing a “substantially optically enriched,” “substantially enantiomerically enriched,” “substantially enantiomerically pure” or a “substantially non-racemic” preparation, which refers to preparations of compositions which have at least 85% by weight of one enantiomer relative to other enantiomer, such as at least 90% by weight, and such as at least 95% by weight. In some embodiments, the enantiomerically enriched composition has a higher potency with respect to therapeutic utility per unit mass than does the racemic mixture of that composition. Enantiomers can be isolated from mixtures by methods known to those skilled in the art, including chiral high pressure liquid chromatography (HPLC) and the formation and crystallization of chiral salts; or enantiomers can be prepared by asymmetric syntheses. See, for example, Jacques, et al., Enantiomers, Racemates and Resolutions (Wiley Interscience, New York, 1981); Wilen, S. H., et al., Tetrahedron 33:2725 (1977); Eliel, E. L. Stereochemistry of Carbon Compounds (McGraw-Hill, N.Y., 1962); and Wilen, S. H. Tables of Resolving Agents and Optical Resolutions p. 268 (E. L. Eliel, Ed., Univ. of Notre Dame Press, Notre Dame, Ind. 1972).

As used herein, alone or as part of another group, “halo” and “halogen” refer to fluorine (fluoro, —F), chlorine (chloro, —Cl), bromine (bromo, —Br), or iodine (iodo, —I).

As used herein, alone or as part of another group, “alkyl” refers to a monoradical of a straight-chain or branched saturated hydrocarbon group having from 1 to 10 carbon atoms (“C₁₋₁₀ alkyl”). In some embodiments, an alkyl group has 1 to 9 carbon atoms (“C₁₋₉ alkyl”). In some embodiments, an alkyl group has 1 to 8 carbon atoms (“C₁₋₈ alkyl”). In some embodiments, an alkyl group has 1 to 7 carbon atoms (“C₁₋₇ alkyl”). In some embodiments, an alkyl group has 1 to 6 carbon atoms (“C₁₋₆ alkyl”). In some embodiments, an alkyl group has 1 to 5 carbon atoms (“C₁₋₅ alkyl”). In some embodiments, an alkyl group has 1 to 4 carbon atoms (“C₁₋₄ alkyl”). In some embodiments, an alkyl group has 1 to 3 carbon atoms (“C₁₋₃ alkyl”). In some embodiments, an alkyl group has 1 to 2 carbon atoms (“C₁₋₂ alkyl”). In some embodiments, an alkyl group has 1 carbon atom (“C₁ alkyl”). In some embodiments, an alkyl group has 2 to 6 carbon atoms (“C₂₋₆ alkyl”). Examples of C₁₋₆ alkyl groups include methyl (C₁), ethyl (C₂), n-propyl (C₃), isopropyl (C₃), n-butyl (C₄), tert-butyl (C₄), sec-butyl (C₄), iso-butyl (C₄), n-pentyl (C₅), 3-pentanyl (C₅), amyl (C₅), neopentyl (C₅), 3-methyl-2-butanyl (C₅), tertiary amyl (C₅), and n-hexyl (C₆). Additional examples of alkyl groups include n-heptyl (C₇), n-octyl (C₈) and the like. Unless otherwise specified, each instance of an alkyl group is independently unsubstituted (an “unsubstituted alkyl”) or substituted (a “substituted alkyl”) with 1, 2, 3, 4, or 5 substituents as described herein. In certain embodiments, the alkyl group is an unsubstituted C₁₋₁₀ alkyl (e.g., —CH₃). In certain embodiments, the alkyl group is a substituted C₁₋₁₀ alkyl.

When a range of values is listed, it is intended to encompass each value and sub-range within the range. For example “C₁₋₆ alkyl” is intended to encompass, C₁, C₂, C₃, C₄, C₅, C₆, C₁₋₆, C₁₋₅, C₁₋₄, C₁₋₃, C₁₋₂, C₂₋₆, C₂₋₅, C₂₋₄, C₂₋₃, C₃₋₆, C₃₋₅, C₃₋₄, C₄₋₆, C₄₋₅, and C₅₋₆ alkyl.

“Perhaloalkyl” as defined herein refers to an alkyl group having from 1 to 10 carbon atoms wherein all of the hydrogen atoms are each independently replaced by a halogen, e.g., selected from fluoro, bromo, chloro or iodo (“C₁₋₁₀ perhaloalkyl”). In some embodiments, the alkyl moiety has 1 to 9 carbon atoms (“C₁₋₉ perhaloalkyl”). In some embodiments, the alkyl moiety has 1 to 8 carbon atoms (“C₁₋₈ perhaloalkyl”). In some embodiments, the alkyl moiety has 1 to 7 carbon atoms (“C₁₋₇ perhaloalkyl”). In some embodiments, the alkyl moiety has 1 to 6 carbon atoms (“C₁₋₆ perhaloalkyl”). In some embodiments, the alkyl moiety has 1 to 5 carbon atoms (“C₁₋₅ perhaloalkyl”). In some embodiments, the alkyl moiety has 1 to 4 carbon atoms (“C₁₋₄ perhaloalkyl”). In some embodiments, the alkyl moiety has 1 to 3 carbon atoms (“C₁₋₃ perhaloalkyl”). In some embodiments, the alkyl moiety has 1 to 2 carbon atoms (“C₁₋₂ perhaloalkyl”). In some embodiments, all of the hydrogen atoms are each replaced with fluoro. In some embodiments, all of the hydrogen atoms are each replaced with chloro. Examples of perhaloalkyl groups include —CF₃, —CF₂CF₃, —CF₂CF₂CF₃, —CCl₃, —CFCl₂, —CF₂Cl and the like.

As used herein, alone or as part of another group, “alkenyl” refers to a monoradical of a straight-chain or branched hydrocarbon group having from 2 to 10 carbon atoms and one or more carbon-carbon double bonds (“C₂₋₁₀ alkenyl”). In some embodiments, an alkenyl group has 2 to 9 carbon atoms (“C₂₋₉ alkenyl”). In some embodiments, an alkenyl group has 2 to 8 carbon atoms (“C₂₋₈ alkenyl”). In some embodiments, an alkenyl group has 2 to 7 carbon atoms (“C₂₋₇ alkenyl”). In some embodiments, an alkenyl group has 2 to 6 carbon atoms (“C₂₋₆ alkenyl”). In some embodiments, an alkenyl group has 2 to 5 carbon atoms (“C₂₋₅ alkenyl”). In some embodiments, an alkenyl group has 2 to 4 carbon atoms (“C₂₋₄ alkenyl”). In some embodiments, an alkenyl group has 2 to 3 carbon atoms (“C₂₋₃ alkenyl”). In some embodiments, an alkenyl group has 2 carbon atoms (“C₂ alkenyl”). The one or more carbon-carbon double bonds can be internal (such as in 2-butenyl) or terminal (such as in 1-butenyl). Examples of C₂₋₄ alkenyl groups include ethenyl (C₂), 1-propenyl (C₃), 2-propenyl (C₃), 1-butenyl (C₄), 2-butenyl (C₄), butadienyl (C₄) and the like. Examples of C₂₋₆ alkenyl groups include the aforementioned C₂₋₄ alkenyl groups as well as pentenyl (C₅), pentadienyl (C₅), hexenyl (C₆) and the like. Additional examples of alkenyl include heptenyl (C₇), octenyl (C₈), octatrienyl (C₈) and the like. Unless otherwise specified, each instance of an alkenyl group is independently unsubstituted (an “unsubstituted alkenyl”) or substituted (a “substituted alkenyl”) with 1, 2, 3, 4, or 5 substituents as described herein. In certain embodiments, the alkenyl group is an unsubstituted C₂₋₁₀ alkenyl. In certain embodiments, the alkenyl group is a substituted C₂₋₁₀ alkenyl.

As used herein, alone or as part of another group, “alkynyl” refers to a monoradical of a straight-chain or branched hydrocarbon group having from 2 to 10 carbon atoms and one or more carbon-carbon triple bonds (“C₂₋₁₀ alkynyl”). In some embodiments, an alkynyl group has 2 to 9 carbon atoms (“C₂₋₉ alkynyl”). In some embodiments, an alkynyl group has 2 to 8 carbon atoms (“C₂₋₈ alkynyl”). In some embodiments, an alkynyl group has 2 to 7 carbon atoms (“C₂₋₇ alkynyl”). In some embodiments, an alkynyl group has 2 to 6 carbon atoms (“C₂₋₆ alkynyl”). In some embodiments, an alkynyl group has 2 to 5 carbon atoms (“C₂₋₅ alkynyl”). In some embodiments, an alkynyl group has 2 to 4 carbon atoms (“C₂₋₄ alkynyl”). In some embodiments, an alkynyl group has 2 to 3 carbon atoms (“C₂₋₃ alkynyl”). In some embodiments, an alkynyl group has 2 carbon atoms (“C₂ alkynyl”). The one or more carbon-carbon triple bonds can be internal (such as in 2-butynyl) or terminal (such as in 1-butynyl). Examples of C₂₋₄ alkynyl groups include, without limitation, ethynyl (C₂), 1-propynyl (C₃), 2-propynyl (C₃), 1-butynyl (C₄), 2-butynyl (C₄) and the like. Examples of C₂₋₆ alkenyl groups include the aforementioned C₂₋₄ alkynyl groups as well as pentynyl (C₅), hexynyl (C₆) and the like. Additional examples of alkynyl include heptynyl (C₇), octynyl (C₈) and the like. Unless otherwise specified, each instance of an alkynyl group is independently unsubstituted (an “unsubstituted alkynyl”) or substituted (a “substituted alkynyl”) with 1, 2, 3, 4, or 5 substituents as described herein. In certain embodiments, the alkynyl group is an unsubstituted C₂₋₁₀ alkynyl. In certain embodiments, the alkynyl group is a substituted C₂₋₁₀ alkynyl.

As used herein, alone or as part of another group, “heteroaliphatic” refers to a monoradical of an acyclic 3- to 14-membered straight-chain or branched-chain having from 2 to 13 carbon atoms and 1 to 4 heteroatoms selected from oxygen, sulfur, phosphorous, and nitrogen, and wherein the point of attachment is a carbon atom (“3-14 membered heteroaliphatic”). In some embodiments, “heteroaliphatic” is a saturated group (“heteroalkyl”). In some embodiments, “heteroaliphatic” is a group containing one or more double bonds (“heteroalkenyl”). In some embodiments, “heteroaliphatic” is a group containing one or more triple bonds (“heteroalkynyl”). Exemplary heteroaliphatic groups include, without limitation, ethers such as methoxyethanyl (—CH₂CH₂OCH₃), ethoxymethanyl (—CH₂OCH₂CH₃), (methoxymethoxy)ethanyl (—CH₂CH₂OCH₂OCH₃), (methoxymethoxy)methanyl (—CH₂OCH₂OCH₃) and (methoxyethoxy)methanyl (—CH₂OCH₂CH₂OCH₃) and the like; amines such as —CH₂CH₂NHCH₃, —CH₂CH₂N(CH₃)₂, —CH₂NHCH₂CH₃, —CH₂N(CH₂CH₃)(CH₃) and the like. Unless otherwise specified, each instance of a heteroaliphatic group is independently unsubstituted (an “unsubstituted heteroaliphatic”) or substituted (a “substituted heteroaliphatic”) with 1-5 substituents as described herein. In certain embodiments, the heteroaliphatic group is an unsubstituted 3-14 membered heteroaliphatic. In certain embodiments, the heteroaliphatic group is a substituted 3-14 membered heteroaliphatic.

As used herein, alone or as part of another group, “carbocyclyl” refers to a radical of a non-aromatic cyclic hydrocarbon group having from 3 to 10 ring carbon atoms (“C₃₋₁₀ carbocyclyl”) and zero heteroatoms in the non-aromatic ring system. In some embodiments, a carbocyclyl group has 3 to 9 ring carbon atoms (“C₃₋₉ carbocyclyl”). In some embodiments, a carbocyclyl group has 3 to 8 ring carbon atoms (“C₃₋₈ carbocyclyl”). In some embodiments, a carbocyclyl group has 3 to 7 ring carbon atoms (“C₃₋₇ carbocyclyl”). In some embodiments, a carbocyclyl group has 3 to 6 ring carbon atoms (“C₃₋₆ carbocyclyl”). In some embodiments, a carbocyclyl group has 3 to 5 ring carbon atoms (“C₃₋₅ carbocyclyl”). In some embodiments, a carbocyclyl group has 3 to 4 ring carbon atoms (“C₃₋₄ carbocyclyl”). In some embodiments, a carbocyclyl group has 5 to 10 ring carbon atoms (“C₅₋₁₀ carbocyclyl”). Examples of C₃₋₆ carbocyclyl groups include, without limitation, cyclopropyl (C₃), cyclobutyl (C₄), cyclopentyl (C₅), cyclopentenyl (C₅), cyclohexyl (C₆), cyclohexenyl (C₆), cyclohexadienyl (C₆) and the like. Examples of C₃₋₈ carbocyclyl groups include the aforementioned C₃₋₆ carbocyclyl groups as well as cycloheptyl (C₇), cycloheptadienyl (C₇), cycloheptatrienyl (C₇), cyclooctyl (C₈), bicyclo[2.2.1]heptanyl, bicyclo[2.2.2]octanyl, and the like. Examples of C₃₋₁₀ carbocyclyl groups include the aforementioned C₃₋₈ carbocyclyl groups as well as octahydro-1H-indenyl, decahydronaphthalenyl, spiro[4.5]decanyl and the like. As the foregoing examples illustrate, in certain embodiments, the carbocyclyl group is either monocyclic (“monocyclic carbocyclyl”) or polycyclic (e.g., containing a fused, bridged or spiro ring system such as a bicyclic system (“bicyclic carbocyclyl”) or tricyclic system (“tricyclic carbocyclyl”)) and can be saturated or can contain one or more carbon-carbon double or triple bonds. “Carbocyclyl” also includes ring systems wherein the carbocyclyl ring, as defined above, is fused with one or more aryl or heteroaryl groups wherein the point of attachment is on the carbocyclyl ring. Unless otherwise specified, each instance of a carbocyclyl group is independently unsubstituted (an “unsubstituted carbocyclyl”) or substituted (a “substituted carbocyclyl”) with 1, 2, 3, 4, or 5 substituents as described herein. In certain embodiments, the carbocyclyl group is an unsubstituted C₃₋₁₀ carbocyclyl. In certain embodiments, the carbocyclyl group is a substituted C₃₋₁₀ carbocyclyl.

In some embodiments, “carbocyclyl” is a monocyclic, saturated carbocyclyl group having from 3 to 10 ring carbon atoms (“C₃₋₁₀ cycloalkyl”). In some embodiments, a cycloalkyl group has 3 to 8 ring carbon atoms (“C₃₋₈ cycloalkyl”). In some embodiments, a cycloalkyl group has 3 to 6 ring carbon atoms (“C₃₋₆ cycloalkyl”). In some embodiments, a cycloalkyl group has 5 to 6 ring carbon atoms (“C₅₋₆ cycloalkyl”). In some embodiments, a cycloalkyl group has 5 to 10 ring carbon atoms (“C₅₋₁₀ cycloalkyl”). Examples of C₅₋₆ cycloalkyl groups include cyclopentyl (C₅) and cyclohexyl (C₅). Examples of C₃₋₆ cycloalkyl groups include the aforementioned C₅₋₆ cycloalkyl groups as well as cyclopropyl (C₃) and cyclobutyl (C₄). Examples of C₃₋₈ cycloalkyl groups include the aforementioned C₃₋₆ cycloalkyl groups as well as cycloheptyl (C₇) and cyclooctyl (C₈). Unless otherwise specified, each instance of a cycloalkyl group is independently unsubstituted (an “unsubstituted cycloalkyl”) or substituted (a “substituted cycloalkyl”) with 1, 2, 3, 4, or 5 substituents as described herein. In certain embodiments, the cycloalkyl group is an unsubstituted C₃₋₁₀ cycloalkyl. In certain embodiments, the cycloalkyl group is a substituted C₃₋₁₀ cycloalkyl.

As used herein, alone or as part of another group, “heterocyclyl” refers to a radical of a 3- to 14-membered non-aromatic ring system having ring carbon atoms and 1 to 4 ring heteroatoms, wherein each heteroatom is independently selected from nitrogen, oxygen, phosphorous, and sulfur (“3-14 membered heterocyclyl”). In heterocyclyl groups that contain one or more nitrogen or phosphorous atoms, the point of attachment can be a carbon, nitrogen, or phosphorous atom, as valency permits. A heterocyclyl group can either be monocyclic (“monocyclic heterocyclyl”) or polycyclic (e.g., a fused, bridged or spiro ring system such as a bicyclic system (“bicyclic heterocyclyl”) or tricyclic system (“tricyclic heterocyclyl”)), and can be saturated or can contain one or more carbon-carbon double or triple bonds. Heterocyclyl polycyclic ring systems can include one or more heteroatoms in one or both rings. “Heterocyclyl” also includes ring systems wherein the heterocycyl ring, as defined above, is fused with one or more carbocycyl groups wherein the point of attachment is either on the carbocycyl or heterocyclyl ring, or ring systems wherein the heterocyclyl ring, as defined above, is fused with one or more aryl or heteroaryl groups, wherein the point of attachment is on the heterocyclyl ring. In some embodiments, a heterocyclyl group is a 5-10 membered non-aromatic ring system having ring carbon atoms and 1-4 ring heteroatoms, wherein each heteroatom is independently selected from nitrogen, oxygen, phosphorous, and sulfur (“5-10 membered heterocyclyl”). In some embodiments, a heterocyclyl group is a 5-8 membered non-aromatic ring system having ring carbon atoms and 1-4 ring heteroatoms, wherein each heteroatom is independently selected from nitrogen, oxygen, phosphorous, and sulfur (“5-8 membered heterocyclyl”). In some embodiments, a heterocyclyl group is a 5-6 membered non-aromatic ring system having ring carbon atoms and 1-4 ring heteroatoms, wherein each heteroatom is independently selected from nitrogen, oxygen, phosphorous, and sulfur (“5-6 membered heterocyclyl”). In some embodiments, the 5-6 membered heterocyclyl has 1-3 ring heteroatoms selected from nitrogen, oxygen, phosphorous, and sulfur. In some embodiments, the 5-6 membered heterocyclyl has 1-2 ring heteroatoms selected from nitrogen, oxygen, phosphorous, and sulfur. In some embodiments, the 5-6 membered heterocyclyl has 1 ring heteroatom selected from nitrogen, oxygen, phosphorous, and sulfur. Exemplary 3-membered heterocyclyls containing 1 heteroatom include, without limitation, azirdinyl, oxiranyl, and thiorenyl. Exemplary 4-membered heterocyclyls containing 1 heteroatom include, without limitation, azetidinyl, oxetanyl and thietanyl. Exemplary 5-membered heterocyclyls containing heteroatom include, without limitation, tetrahydrofuranyl, dihydrofuranyl, tetrahydrothiophenyl, dihydrothiophenyl, pyrrolidinyl, dihydropyrrolyl and pyrrolyl-2,5-dione. Exemplary 5-membered heterocyclyls containing 2 heteroatoms include, without limitation, dioxolanyl, oxathiolanyl and dithiolanyl. Exemplary 5-membered heterocyclyls containing 3 heteroatoms include, without limitation, triazolinyl, oxadiazolinyl, and thiadiazolinyl. Exemplary 6-membered heterocyclyl groups containing 1 heteroatom include, without limitation, piperidinyl, tetrahydropyranyl, dihydropyridinyl, and thianyl. Exemplary 6-membered heterocyclyl groups containing 2 heteroatoms include, without limitation, piperazinyl, morpholinyl, dithianyl, and dioxanyl. Exemplary 6-membered heterocyclyl groups containing 2 heteroatoms include, without limitation, triazinanyl. Exemplary 7-membered heterocyclyl groups containing 1 heteroatom include, without limitation, azepanyl, oxepanyl and thiepanyl. Exemplary 8-membered heterocyclyl groups containing 1 heteroatom include, without limitation, azocanyl, oxecanyl and thiocanyl. Exemplary bicyclic heterocyclyl groups include, without limitation, indolinyl, isoindolinyl, dihydrobenzofuranyl, dihydrobenzothienyl, tetrahydrobenzothienyl, tetrahydrobenzofuranyl, tetrahydroindolyl, tetrahydroquinolinyl, tetrahydroisoquinolinyl, decahydroquinolinyl, decahydroisoquinolinyl, octahydrochromenyl, octahydroisochromenyl, decahydronaphthyridinyl, decahydro-1,8-naphthyridinyl, octahydropyrrolo[3,2-b]pyrrole, indolinyl, phthalimidyl, naphthalimidyl, chromanyl, chromenyl, 1H-benzo[e][1,4]diazepinyl, 1,4,5,7-tetrahydropyrano[3,4-b]pyrrolyl, 5,6-dihydro-4H-furo[3,2-b]pyrrolyl, 6,7-dihydro-5H-furo[3,2-b]pyranyl, 5,7-dihydro-4H-thieno[2,3-c]pyranyl, 2,3-dihydro-1H-pyrrolo[2,3-b]pyridinyl, 2,3-dihydrofuro[2,3-b]pyridinyl, 4,5,6,7-tetrahydro-1H-pyrrolo[2,3-b]pyridinyl, 4,5,6,7-tetrahydro furo[3,2-c]pyridinyl, 4,5,6,7-tetrahydrothieno[3,2-b]pyridinyl, 1,2,3,4-tetrahydro-1,6-naphthyridinyl, and the like. Unless otherwise specified, each instance of heterocyclyl is independently unsubstituted (an “unsubstituted heterocyclyl”) or substituted (a “substituted heterocyclyl”) with 1, 2, 3, 4, or 5 substituents as described herein. In certain embodiments, the heterocyclyl group is an unsubstituted 3-14 membered heterocyclyl. In certain embodiments, the heterocyclyl group is a substituted 3-14 membered heterocyclyl.

As used herein, alone or as part of another group, “aryl” refers to a radical of a monocyclic or polycyclic (e.g., bicyclic or tricyclic) aromatic ring system (e.g., having 6, 10 or 14 π electrons shared in a cyclic array) having 6-14 ring carbon atoms and zero heteroatoms provided in the aromatic ring system (“C₆₋₁₄ aryl”). In some embodiments, an aryl group has 6 ring carbon atoms (“C₆ aryl”; e.g., phenyl). In some embodiments, an aryl group has 10 ring carbon atoms (“C₁₀ aryl”; e.g., naphthyl, such as 1-naphthyl and 2-naphthyl). In some embodiments, an aryl group has 14 ring carbon atoms (“C₁₄ aryl”; e.g., anthracyl). “Aryl” also includes ring systems wherein the aryl ring, as defined above, is fused with one or more carbocyclyl or heterocyclyl groups wherein the radical or point of attachment is on the aryl ring. Unless otherwise specified, each instance of an aryl group is independently unsubstituted (an “unsubstituted aryl”) or substituted (a “substituted aryl”) with 1, 2, 3, 4, or 5 substituents as described herein. In certain embodiments, the aryl group is an unsubstituted C₆₋₁₄ aryl. In certain embodiments, the aryl group is a substituted C₆₋₁₄ aryl.

As used herein, alone or part of another group, “aralkyl” refers to a C₁₋₁₀ alkyl group as defined herein substituted by a C₆₋₁₄ aryl group as defined herein, wherein the point of attachment is on the alkyl group (“C₁₋₁₀ aralkyl”).

As used herein, alone or as part of another group, “heteroaryl” refers to a radical of a 5-14 membered monocyclic or polycyclic (e.g., bicyclic or tricyclic) aromatic ring system (e.g., having 6, 10 or 14 π electrons shared in a cyclic array) having ring carbon atoms and 1-4 ring heteroatoms provided in the aromatic ring system, wherein each heteroatom is independently selected from nitrogen, oxygen, phosphorous, and sulfur (“5-14 membered heteroaryl”). In heteroaryl groups that contain one or more nitrogen or phosphorous atoms, the point of attachment can be a carbon, phosphorous or nitrogen atom, as valency permits. Heteroaryl polycyclic ring systems can include one or more heteroatoms in one or both rings. “Heteroaryl” also includes ring systems wherein the heteroaryl ring, as defined above, is fused with one or more aryl groups wherein the point of attachment is either on the aryl or on the heteroaryl ring, or wherein the heteroaryl ring, as defined above, is fused with one or more carbocycyl or heterocycyl groups wherein the point of attachment is on the heteroaryl ring. For polycyclic heteroaryl groups wherein one ring does not contain a heteroatom (e.g., indolyl, quinolinyl, carbazolyl and the like) the point of attachment can be on either ring, i.e., either the ring bearing a heteroatom (e.g., 2-indolyl) or the ring that does not contain a heteroatom (e.g., 5-indolyl). In some embodiments, a heteroaryl group is a 5-10 membered aromatic ring system having ring carbon atoms and 1-4 ring heteroatoms provided in the aromatic ring system, wherein each heteroatom is independently selected from nitrogen, oxygen, phosphorous, and sulfur (“5-10 membered heteroaryl”). In some embodiments, a heteroaryl group is a 5-8 membered aromatic ring system having ring carbon atoms and 1-4 ring heteroatoms provided in the aromatic ring system, wherein each heteroatom is independently selected from nitrogen, oxygen, phosphorous, and sulfur (“5-8 membered heteroaryl”). In some embodiments, a heteroaryl group is a 5-6 membered aromatic ring system having ring carbon atoms and 1-4 ring heteroatoms provided in the aromatic ring system, wherein each heteroatom is independently selected from nitrogen, oxygen, phosphorous, and sulfur (“5-6 membered heteroaryl”). In some embodiments, the 5-6 membered heteroaryl has 1-3 ring heteroatoms selected from nitrogen, oxygen, phosphorous, and sulfur. In some embodiments, the 5-6 membered heteroaryl has 1-2 ring heteroatoms selected from nitrogen, oxygen, phosphorous, and sulfur. In some embodiments, the 5-6 membered heteroaryl has 1 ring heteroatom selected from nitrogen, oxygen, phosphorous, and sulfur. Exemplary 5-membered heteroaryls containing 1 heteroatom include, without limitation, pyrrolyl, furanyl and thiophenyl. Exemplary 5-membered heteroaryls containing 2 heteroatoms include, without limitation, imidazolyl, pyrazolyl, oxazolyl, isoxazolyl, thiazolyl, and isothiazolyl. Exemplary 5-membered heteroaryls containing 3 heteroatoms include, without limitation, triazolyl, oxadiazolyl, and thiadiazolyl. Exemplary 5-membered heteroaryls containing 4 heteroatoms include, without limitation, tetrazolyl. Exemplary 6-membered heteroaryls containing 1 heteroatom include, without limitation, pyridinyl. Exemplary 6-membered heteroaryls containing 2 heteroatoms include, without limitation, pyridazinyl, pyrimidinyl and pyrazinyl. Exemplary 6-membered heteroaryls containing 3 or 4 heteroatoms include, without limitation, triazinyl and tetrazinyl, respectively. Exemplary 7 membered heteroaryls containing 1 heteroatom include, without limitation, azepinyl, oxepinyl and thiepinyl. Exemplary 5,6-bicyclic heteroaryls include, without limitation, indolyl, isoindolyl, indazolyl, benzotriazolyl, benzothiophenyl, isobenzothiophenyl, benzofuranyl, benzoisofuranyl, benzimidazolyl, benzoxazolyl, benzisoxazolyl, benzoxadiazolyl, benzthiazolyl, benzisothiazolyl, benzthiadiazolyl, indolizinyl, and purinyl. Exemplary 6,6-bicyclic heteroaryls include, without limitation, naphthyridinyl, pteridinyl, quinolinyl, isoquinolinyl, cinnolinyl, quinoxalinyl, phthalazinyl and quinazolinyl. Exemplary tricyclic heteroaryls include, without limitation, phenanthridinyl, dibenzofuranyl, carbazolyl, acridinyl, phenothiazinyl, phenoxazinyl and phenazinyl. Unless otherwise specified, each instance of a heteroaryl group is independently unsubstituted (an “unsubstituted heteroaryl”) or substituted (a “substituted heteroaryl”) with 1, 2, 3, 4, or 5 substituents as described herein. In certain embodiments, the heteroaryl group is an unsubstituted 5-14 membered heteroaryl. In certain embodiments, the heteroaryl group is a substituted 5-14 membered heteroaryl.

As used herein, alone or part of another group, “heteroaralkyl” refers to a C₁₋₁₀ alkyl group as defined herein substituted by a 5-14 membered heteroaryl group as defined herein, wherein the point of attachment is on the alkyl group (“C₁₋₁₀ heteroaralkyl”).

As used herein, a “covalent bond” or “direct bond” refers to a single bond joining two groups.

As used herein, the term “partially unsaturated” refers to a ring moiety that includes at least one double or triple bond. The term “partially unsaturated” is intended to encompass rings having multiple sites of unsaturation, but is not intended to include aryl or heteroaryl moieties, as herein defined.

As used herein a “divalent” group, such as a divalent alkyl, divalent alkenyl, divalent alkynyl, divalent heteroaliphatic, divalent carbocyclyl, divalent heterocyclyl, divalent aryl or divalent heteroaryl group, refers to a bis-radical of the group, as defined herein.

Monovalent or divalent alkyl, alkenyl, alkynyl, heteroaliphatic, carbocyclyl, heterocyclyl, aryl and heteroaryl groups, as defined herein, are either “substituted” or “unsubstituted” alkyl, “substituted” or “unsubstituted” alkenyl, “substituted” or “unsubstituted” alkynyl, “substituted” or “unsubstituted” heteroaliphatic, “substituted” or “unsubstituted” carbocyclyl, “substituted” or “unsubstituted” heterocyclyl, “substituted” or “unsubstituted” aryl or “substituted” or “unsubstituted” heteroaryl groups. In general, the term “substituted” means that at least one hydrogen present on a group (e.g., a carbon or nitrogen atom, etc.) is replaced with a permissible substituent, e.g., a substituent which upon substitution results in a stable compound, e.g., a compound which does not spontaneously undergo transformation such as by rearrangement, cyclization, elimination, or other reaction. Unless otherwise indicated, a “substituted” group can have a substituent at one or more substitutable positions of the group, and when more than one position in any given structure is substituted, the substituent is either the same or different at each position. A group referred to as “not hydrogen” indicates that the group is an exemplary and permissible substituent as described herein.

Exemplary substituents include, but are not limited to, halogen (i.e., fluoro (—F), bromo (—Br), chloro (—Cl), and iodo (—I)), —CN, —NO₂, —N₃, —SO₂H, —SO₃H, —OH, —OR^(aa), —ON(R^(bb))₂, —N(R^(bb))₂, —N(OR^(cc))R^(bb), —SH, —SR^(aa), —SSR^(cc), —C(═O)R^(aa), —CO₂H, —CHO, —C(OR^(cc))₂, —CO₂R^(aa), —OC(═O)R^(aa), —OCO₂R^(aa), —C(═O)N(R^(bb))₂, —OC(═O)N(R^(bb))₂, —NR^(bb)C(═O)R^(aa), —NR^(bb)CO₂R^(aa), —NR^(bb)C(═O)N(R^(bb))₂, —C(═NR^(bb))OR^(aa), —OC(═NR^(bb))R^(aa), —OC(═NR^(bb))OR^(aa), —C(═NR^(bb))N(R^(bb))₂, —OC(═NR^(bb))N(R^(bb))₂, —NR^(bb)C(═NR^(bb))N(R^(bb))₂, —C(═O)NR^(bb)SO₂R^(aa), —NR^(bb)SO₂R^(aa), —SO₂N(R^(bb))₂, —SO₂R^(aa), —SO₂OR^(aa), —OSO₂R^(aa), —S(═O)R^(aa), —OS(═O)R^(aa), —Si(R^(aa))₃, —OSi(R^(aa))₃, —C(═S)N(R^(bb))₂, —C(═O)SR^(aa), —C(═S)SR^(aa), —SC(S)SR^(aa), —P(═O)₂R^(aa), —OP(═O)₂R^(aa), —P(═O)(R^(aa))₂, —OP(═O)(R^(aa))₂, —OP(═O)(OR^(cc))₂, —P(═O)₂N(R^(bb))₂, —OP(═O)₂N(R^(bb))₂, —P(═O)(NR^(bb))₂, —OP(═O)(NR^(bb))₂, —NR^(bb)P(═O)(OR^(cc))₂, —NR^(bb)P(═O)(NR^(bb))₂, —P(R^(cc))₂, —P(R^(cc))₃, —OP(R^(cc))₂, —OP(R^(cc))₃, —B(OR^(cc))₂, or —BR^(aa)(OR^(cc)), ═O, ═S, ═NN(R^(bb))₂, ═NNR^(bb)C(O)R^(aa), ═NNR^(bb)CO₂R^(aa), ═NNR^(bb)S(O)₂R^(aa), ═NR^(bb), ═NOR^(cc), C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, wherein each alkyl, alkenyl, alkynyl, carbocyclyl, heterocyclyl, aryl, and heteroaryl is independently unsubstituted or substituted with 1-5 R^(dd) groups;

wherein:

each instance of R^(aa) is, independently, selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, wherein each alkyl, alkenyl, alkynyl, heteroaliphatic, carbocyclyl, heterocyclyl, aryl, and heteroaryl is independently unsubstituted or substituted with 1-5 R^(dd) groups;

each instance of R^(bb) is, independently, selected from hydrogen, —OH, —OR^(aa), —N(R^(cc))₂, —CN, —C(═O)R^(aa), —C(═O)N(R^(cc))₂, —CO₂R^(aa), —SO₂R^(aa), —C(═NR^(cc))OR^(aa), —C(═NR^(cc))N(R^(cc))₂, —SO₂N(R^(cc))₂, —SO₂R^(cc), —SO₂OR^(cc), —SOR^(aa), —C(═S)N(R^(cc))₂, —C(═O)SR^(cc), —C(═S)SR^(cc), —P(═O)₂R^(aa), —P(═O)(R^(aa))₂, —P(═O)₂N(R^(cc))₂, —P(═O)(NR^(cc))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(bb) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring, wherein each alkyl, alkenyl, alkynyl, heteroaliphatic, carbocyclyl, heterocyclyl, aryl, and heteroaryl is independently unsubstituted or substituted with 1-5 R^(dd) groups;

each instance of R^(cc) is, independently, selected from hydrogen, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(cc) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring, wherein each alkyl, alkenyl, alkynyl, heteroaliphatic carbocyclyl, heterocyclyl, aryl, and heteroaryl is independently unsubstituted or substituted with 1-5 R^(dd) groups;

each instance of R^(dd) is, independently, selected from halogen, —CN, —NO₂, —N₃, —SO₂H, —SO₃H, —OH, —OR^(ee), —ON(R^(ff))₂, —N(R^(ff))₂, —N(OR^(ee))R^(ff), —SH, —SR^(ee), —SSR^(ee), —C(O)R^(ee), —CO₂H, —CO₂R^(ee), —OC(O)R^(ee), —OCO₂R^(ee), —C(O)N(R^(ff))₂, —OC(O)N(R^(ff))₂, —NR^(ff)C(O)R^(ee), —NR^(ff)CO₂R^(ee), —NR^(ff)C(O)N(R^(ff))₂, —C(NR^(ff))OR^(ee), —OC(NR^(ff))R^(ee), —OC(NR^(ff))OR^(ee), —C(NR^(ff))N(R^(ff))₂, —OC(NR^(ff))N(R^(ff))₂, —NR^(ff)C(NR^(ff))N(R^(ff))₂, —NR^(ff)SO₂R^(ee), —SO₂N(R^(ff))₂, —SO₂R^(ee), —SO₂OR^(ee), —OSO₂R^(ee), —SOR^(ee), —Si(R^(ee))₃, —OSi(R^(ee))₃, —C(S)N(R^(ff))₂, —C(O)SR^(ee), —C(S)SR^(ee), —SC(S)SR^(ee), —P(O)₂R^(ee), —P(O)(R^(ee))₂, —OP(O)(R^(ee))₂, —OP(O)(OR^(ee))₂, ═O, ═S, C₁₋₆ alkyl, C₁₋₆ perhaloalkyl, C₂₋₆ alkenyl, C₂₋₆ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-10 membered heterocyclyl, C₆₋₁₀ aryl, 5-10 membered heteroaryl, wherein each alkyl, alkenyl, alkynyl, heteroaliphatic, carbocyclyl, heterocyclyl, aryl, and heteroaryl is independently unsubstituted or substituted with 1-5 R^(gg) groups;

each instance of R^(ee) is, independently, selected from C₁₋₆ alkyl, C₁₋₆ perhaloalkyl, C₂₋₆ alkenyl, C₂₋₆ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, C₆₋₁₀ aryl, 3-10 membered heterocyclyl, and 3-10 membered heteroaryl, wherein each alkyl, alkenyl, alkynyl, heteroaliphatic, carbocyclyl, heterocyclyl, aryl, and heteroaryl is independently unsubstituted or substituted with 1-5 R^(gg) groups;

each instance of R^(ff) is, independently, selected from hydrogen, C₁₋₆ alkyl, C₁₋₆ perhaloalkyl, C₂₋₆ alkenyl, C₂₋₆ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-10 membered heterocyclyl, C₆₋₁₀ aryl and 5-10 membered heteroaryl, or two R^(ff) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring, wherein each alkyl, alkenyl, alkynyl, heteroaliphatic, carbocyclyl, heterocyclyl, aryl, and heteroaryl is independently unsubstituted or substituted with 1-5 R^(gg) groups; and

each instance of R^(gg) is, independently, halogen, —CN, —NO₂, —N₃, —SO₂H, —SO₃H, —OH, —OC₁₋₆ alkyl, —ON(C₁₋₆ alkyl)₂, —N(C₁₋₆ alkyl)₂, —N(OC₁₋₆ alkyl)(C₁₋₆ alkyl), —N(OH)(C₁₋₆ alkyl), —NH(OH), —SH, —S(C₁₋₆ alkyl), —SS(C₁₋₆ alkyl), —C(O)(C₁₋₆ alkyl), —CO₂H, —CO₂(C₁₋₆ alkyl), —OC(O)(C₁₋₆ alkyl), —OCO₂(C₁₋₆ alkyl), —C(O)NH₂, —C(O)N(C₁₋₆ alkyl)₂, —OC(O)NH(C₁₋₆ alkyl), —NHC(O)(C₁₋₆ alkyl), —N(C₁₋₆ alkyl)C(O)(C₁₋₆ alkyl), —NHCO₂(C₁₋₆ alkyl), —NHC(O)N(C₁₋₆ alkyl)₂, —NHC(O)NH(C₁₋₆ alkyl), —NHC(O)NH₂, —C(NH)O(C₁₋₆ alkyl), —OC(NH)(C₁₋₆ alkyl), —OC(NH)OC₁₋₆ alkyl, —C(NH)N(C₁₋₆ alkyl)₂, —C(NH)NH(C₁₋₆ alkyl), —C(NH)NH₂, —OC(NH)N(C₁₋₆ alkyl)₂, —OC(NH)NH(C₁₋₆ alkyl), —OC(NH)NH₂, —NHC(NH)N(C₁₋₆ alkyl)₂, —NHC(NH)NH₂, —NHSO₂(C₁₋₆ alkyl), —SO₂N(C₁₋₆ alkyl)₂, —SO₂NH(C₁₋₆ alkyl), —SO₂NH₂, —SO₂C₁₋₆ alkyl, —SO₂OC₁₋₆ alkyl, —OSO₂C₁₋₆ alkyl, —SOC₁₋₆ alkyl, —Si(C₁₋₆ alkyl)₃, —OSi(C₁₋₆ alkyl)₃, —C(S)N(C₁₋₆ alkyl)₂, —C(S)NH(C₁₋₆ alkyl), —C(S)NH₂, —C(O)S(C₁₋₆ alkyl), —C(S)SC₁₋₆ alkyl, —SC(S)SC₁₋₆ alkyl, —P(O)₂(C₁₋₆ alkyl), —P(O)(C₁₋₆ alkyl)₂, —OP(O)(C₁₋₆ alkyl)₂, —OP(O)(OC₁₋₆ alkyl)₂, C₁₋₆ alkyl, C₁₋₆ perhaloalkyl, C₂₋₆ alkenyl, C₂₋₆ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, C₆₋₁₀ aryl, 3-10 membered heterocyclyl, 5-10 membered heteroaryl, ═O or ═S.

These and other exemplary substituents are described in more detail in the Detailed Description, the Exemplification and in the claims. The term “substituents” is not intended to be limited in any manner by the above exemplary listing of substituents.

As used herein, a “pharmaceutically acceptable form thereof” includes pharmaceutically acceptable salts, hydrates, solvates, prodrugs, tautomers, isomers, and/or polymorphs of a compound provided herein, as defined below and herein.

In certain embodiments, the pharmaceutically acceptable form thereof is a pharmaceutically acceptable salt. As used herein, the term “pharmaceutically acceptable salt” refers to those salts which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of humans and lower animals without undue toxicity, irritation, allergic response and the like, and are commensurate with a reasonable benefit/risk ratio. Pharmaceutically acceptable salts are well known in the art. For example, Berge et al. describes pharmaceutically acceptable salts in detail in J. Pharmaceutical Sciences (1977) 66:1-19. Pharmaceutically acceptable salts of the compounds provided herein include those derived from suitable inorganic and organic acids and bases. Examples of pharmaceutically acceptable, nontoxic acid addition salts are salts of an amino group formed with inorganic acids such as hydrochloric acid, hydrobromic acid, phosphoric acid, sulfuric acid and perchloric acid or with organic acids such as acetic acid, oxalic acid, maleic acid, tartaric acid, citric acid, succinic acid or malonic acid or by using other methods used in the art such as ion exchange. Other pharmaceutically acceptable salts include adipate, alginate, ascorbate, aspartate, benzenesulfonate, benzoate, bisulfate, borate, butyrate, camphorate, camphorsulfonate, citrate, cyclopentanepropionate, digluconate, dodecylsulfate, ethanesulfonate, formate, fumarate, glucoheptonate, glycerophosphate, gluconate, hemisulfate, heptanoate, hexanoate, hydroiodide, 2-hydroxy-ethanesulfonate, lactobionate, lactate, laurate, lauryl sulfate, malate, maleate, malonate, methanesulfonate, 2-naphthalenesulfonate, nicotinate, nitrate, oleate, oxalate, palmitate, pamoate, pectinate, persulfate, 3-phenylpropionate, phosphate, picrate, pivalate, propionate, stearate, succinate, sulfate, tartrate, thiocyanate, p-toluenesulfonate, undecanoate, valerate salts, and the like. Salts derived from appropriate bases include alkali metal, alkaline earth metal, ammonium and —N⁺(C₁₋₄alkyl)₄ salts. Representative alkali or alkaline earth metal salts include sodium, lithium, potassium, calcium, magnesium, and the like. Further pharmaceutically acceptable salts include, when appropriate, nontoxic ammonium, quaternary ammonium, and amine cations formed using counterions such as halide, hydroxide, carboxylate, sulfate, phosphate, nitrate, lower alkyl sulfonate and aryl sulfonate.

In certain embodiments, the pharmaceutically acceptable form thereof is a hydrate or solvate. As used herein, the term “hydrate” refers to a compound non-covalently associated with one or more molecules of water, which in some embodiments can be crystalline. Likewise, “solvate” refers to a compound non-covalently associated with one or more molecules of an organic solvent, which in some embodiments can be crystalline.

In certain embodiments, the pharmaceutically acceptable form thereof is a prodrug. As used herein, the term “prodrug” refers to a derivative of a parent compound that requires transformation within the body in order to release the parent compound.

The term “prodrug” refers to compounds that are transformed in vivo to yield a disclosed compound or a pharmaceutically acceptable form of the compound. The transformation can occur by various mechanisms, such as, but not limited to, through hydrolysis in blood. In certain cases, a prodrug has improved physical and/or delivery properties over the parent compound. Prodrugs are typically designed to enhance pharmaceutically and/or pharmacokinetically based properties associated with the parent compound. Exemplary advantages of a prodrug can include, but are not limited to, its physical properties, such as enhanced water solubility for parenteral administration at physiological pH compared to the parent compound, or it enhances absorption from the digestive tract, or it can enhance drug stability for long-term storage.

For example, if a disclosed compound or a pharmaceutically acceptable form of the compound contains a carboxylic acid functional group, a prodrug can comprise an ester formed by the replacement of the hydrogen atom of the acid group with a group such as (C₁-C₈)alkyl, (C₂-C₁₂)alkanoyloxymethyl, 1-(alkanoyloxy)ethyl having from 4 to 9 carbon atoms, 1-methyl-1-(alkanoyloxy)-ethyl having from 5 to 10 carbon atoms, alkoxycarbonyloxymethyl having from 3 to 6 carbon atoms, 1-(alkoxycarbonyloxy)ethyl having from 4 to 7 carbon atoms, 1-methyl-1-(alkoxycarbonyloxy)ethyl having from 5 to 8 carbon atoms, N-(alkoxycarbonyl)aminomethyl having from 3 to 9 carbon atoms, 1-(N-(alkoxycarbonyl)amino)ethyl having from 4 to 10 carbon atoms, 3-phthalidyl, 4-crotonolactonyl, gamma-butyrolacton-4-yl, di-N,N—(C₁-C₂)alkylamino(C₂-C₃)alkyl (such as (3-dimethylaminoethyl), carbamoyl-(C₁-C₂)alkyl, N,N-di(C₁-C₂)alkylcarbamoyl-(C₁-C₂)alkyl and piperidino-, pyrrolidino- or morpholino(C₂-C₃)alkyl.

Similarly, if a disclosed compound or a pharmaceutically acceptable form of the compound contains an alcohol functional group, a prodrug can be formed by the replacement of the hydrogen atom of the alcohol group with a group such as (C₁-C₆)alkanoyloxymethyl, 1-((C₁-C₆)alkanoyloxy)ethyl, 1-methyl-1-((C₁-C₆)alkanoyloxy)ethyl (C₁-C₆)alkoxycarbonyloxymethyl, N—(C₁-C₆)alkoxycarbonylaminomethyl, succinoyl, (C₁-C₆)alkanoyl, α-amino(C₁-C₄)alkanoyl, arylacyl and α-aminoacyl, or α-aminoacyl-α-aminoacyl, where each α-aminoacyl group is independently selected from the naturally occurring L-amino acids, P(O)(OH)₂, —P(O)(O(C₁-C₆)alkyl)₂ or glycosyl (the radical resulting from the removal of a hydroxyl group of the hemiacetal form of a carbohydrate).

If a disclosed compound or a pharmaceutically acceptable form of the compound incorporates an amine functional group, a prodrug can be formed by the replacement of a hydrogen atom in the amine group with a group such as R-carbonyl, RO-carbonyl, NRR′-carbonyl where R and R′ are each independently (C₁-C₁₀)alkyl, (C₃-C₇)cycloalkyl, benzyl, or R-carbonyl is a natural α-aminoacyl or natural α-aminoacyl-natural α-aminoacyl, C(OH)C(O)OY¹ wherein Y¹ is H, (C₁-C₆)alkyl or benzyl, —C(OY²)Y³ wherein Y² is (C₁-C₄) alkyl and Y³ is (C₁-C₆)alkyl, carboxy(C₁-C₆)alkyl, amino(C₁-C₄)alkyl or mono-N— or di-N,N—(C₁-C₆)alkylaminoalkyl, —C(Y⁴)Y⁵ wherein Y⁴ is H or methyl and Y⁵ is mono-N— or di-N,N—(C₁-C₆)alkylamino, morpholino, piperidin-1-yl or pyrrolidin-1-yl.

In certain embodiments, the pharmaceutically acceptable form thereof is a tautomer. As used herein, the term “tautomer” includes two or more interconvertable compounds resulting from at least one formal migration of a hydrogen atom and at least one change in valency (e.g., a single bond to a double bond, a triple bond to a single bond, or vice versa). The exact ratio of the tautomers depends on several factors, including temperature, solvent, and pH. Tautomerizations (i.e., the reaction providing a tautomeric pair) can be catalyzed by acid or base, or can occur without the action or presence of an external agent. Exemplary tautomerizations include, but are not limited to, keto-to-enol; amide-to-imide; lactam-to-lactim; enamine-to-imine; and enamine-to-(a different) enamine tautomerizations.

In certain embodiments, the pharmaceutically acceptable form thereof is an isomer. As used herein, the term “isomer” includes any and all geometric isomers and stereoisomers. For example, “isomers” include cis- and trans-isomers, E- and Z-isomers, R- and S-enantiomers, diastereomers, (D)-isomers, (L)-isomers, racemic mixtures thereof, and other mixtures thereof, as falling within the scope of this disclosure. For instance, an isomer/enantiomer can, in some embodiments, be provided substantially free of the corresponding enantiomer, and may also be referred to as “optically enriched.” “Optically-enriched,” as used herein, means that the compound is made up of a significantly greater proportion of one enantiomer. In certain embodiments, the compound provided herein is made up of at least about 90% by weight of one enantiomer. In other embodiments the compound is made up of at least about 95%, 98%, or 99% by weight of one enantiomer. Enantiomers can be isolated from racemic mixtures by any method known to those skilled in the art, including chiral high pressure liquid chromatography (HPLC), the formation and crystallization of chiral salts, or prepared by asymmetric syntheses. See, for example, Enantiomers, Racemates and Resolutions (Jacques, Ed., Wiley Interscience, New York, 1981); Wilen et al., Tetrahedron 33:2725 (1977); Stereochemistry of Carbon Compounds (E. L. Eliel, Ed., McGraw-Hill, N.Y., 1962); and Tables of Resolving Agents and Optical Resolutions p. 268 (E. L. Eliel, Ed., Univ. of Notre Dame Press, Notre Dame, Ind. 1972).

In certain embodiments, the pharmaceutically acceptable form thereof is a polymorph. As used herein, “polymorph” refers to a compound having more than one crystal structure, e.g., resulting from differences in molecular packing and/or molecular conformation of the compound in the solid state.

The disclosure also embraces isotopically labeled compounds which are identical to those recited herein, except that one or more atoms are replaced by an atom having an atomic mass or mass number different from the atomic mass or mass number usually found in nature. Examples of isotopes that can be incorporated into disclosed compounds include isotopes of hydrogen, carbon, nitrogen, oxygen, phosphorus, fluorine and chlorine, such as ²H, ³H, ¹³C, ¹⁴C, ¹⁵N, ¹⁸O, ¹⁷O, ³¹P, ³²P, ³⁵S, ¹⁸F, and ³⁶Cl, respectively.

Certain isotopically-labeled disclosed compounds (e.g., those labeled with ³H and ¹⁴C) are useful in compound and/or substrate tissue distribution assays. Tritiated (i.e., ³H) and carbon-14 (i.e., ¹⁴C) isotopes can allow for ease of preparation and detectability. Further, substitution with heavier isotopes such as deuterium (i.e., ²H) can afford certain therapeutic advantages resulting from greater metabolic stability (e.g., increased in vivo half-life or reduced dosage requirements). Isotopically labeled disclosed compounds can generally be prepared by following procedures analogous to those disclosed in the Exemplification section herein by substituting an isotopically labeled reagent for a non-isotopically labeled reagent.

DETAILED DESCRIPTION 1. Brief Description of Figures

FIG. 1 illustrates a schematic diagram of subcutaneous mouse xenograft model for assaying papillomaviruses.

FIG. 2 illustrates a schematic diagram of cutaneous mouse xenograft model for assaying papillomaviruses.

2. Compounds

Without being limited by a particular theory, the present disclosure is based on the discovery that tetrazolones are inhibitors of human fatty acid synthase (FASN) and thus are useful in the treatment of FASN-mediated diseases, disorders or conditions. Further, without being limited by a particular theory, in certain embodiments, the compounds provided herein can inhibit long chain fatty acid elongase (ELOVL) such as ELOVL 6. Thus, in some embodiments, compounds provided herein are useful in the treatment of ELOVL-mediated diseases, disorders or conditions.

For example, in one aspect, provided herein is a compound of formula (I):

or a pharmaceutically acceptable form thereof;

wherein:

R^(A) is selected from C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl and 5-14 membered heteroaryl;

R^(B) is selected from C₁₋₁₀ alkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl and 5-14 membered heteroaryl;

R^(C) is selected from hydrogen, —OH, —OR^(C1), —ON(R^(C2))₂, —N(R^(C2))₂, —C(═O)R^(C1), —CHO, —CO₂R^(C1), —C(═O)N(R^(C2))₂, —C(═NR^(C2))OR^(C1), —C(═NR^(C2))N(R^(C2))₂, —SO₂R^(C1), —S(═O)R^(C1), —Si(R^(C1))₃, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl;

wherein:

each instance of R^(C1) is, independently, selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl; and

each instance of R^(C2) is, independently, selected from hydrogen, —OH, —OR^(C1), —N(R^(C3))₂, —CN, —C(═O)R^(C1), —C(═O)N(R^(C3))₂, —CO₂R^(C1), —SO₂R^(C1), —C(NR^(C3))OR^(C1), —C(═NR)N(R^(C3))₂, —SO₂N(R^(C3))₂, —SO₂R^(C3), —SO₂OR^(C3), —SOR^(C1), —C(═S)N(R^(C3))₂, —C(═O)SR^(C3), —C(═S)SR^(C3), —P(═O)₂R^(C1), —P(═O)(R^(C1))₂, —P(═O)₂N(R^(C3))₂, —P(═O)(NR^(C3))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(C2) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring;

or R^(B) and R^(C) together with the nitrogen (N) atom to which each is attached are joined to form a 5-14 membered heterocyclyl or heteroaryl ring.

In one embodiment, provided herein is a compound of formula (I):

or a pharmaceutically acceptable form thereof;

wherein:

R^(A) is selected from C₆₋₁₄ aryl and 5-14 membered heteroaryl;

R^(B) is selected from C₆₋₁₄ aryl and 5-14 membered heteroaryl;

R^(C) is selected from —OH, —OR^(C1), —ON(R^(C2))₂, —N(R^(C2))₂, —C(═O)R^(C1), —CHO, —CO₂R^(C1), —C(═O)N(R^(C2))₂, —C(═NR^(C2))OR^(C1), —C(═NR^(C2))N(R^(C2))₂, —SO₂R^(C1), —S(═O)R^(C1), —Si(R^(C1))₃, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, with the proviso that R^(C) is not —CH₃;

each instance of R^(C1) is, independently, selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl;

each instance of R^(C2) is, independently, selected from hydrogen, —OH, —OR^(C1), —N(R^(C3))₂, —CN, —C(═O)R^(C1), —C(═O)N(R^(C3))₂, —CO₂R^(C1), —SO₂R^(C1), —C(═NR^(C3))OR^(C1), —C(═NR^(C3))N(R^(C3))₂, —SO₂N(R^(C3))₂, —SO₂R^(C3), —SO₂OR^(C3), —SOR^(C1), —C(═S)N(R^(C3))₂, —C(═O)SR^(C3), —C(═S)SR^(C3), —P(═O)₂R^(C1), —P(═O)(R^(C1))₂, —P(═O)₂N(R^(C3))₂, —P(═O)(NR^(C3))₂, C₂₋₁₀ alkyl, C₂₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(C2) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring;

or R^(B) and R^(C) together with the nitrogen (N) atom to which each is attached are joined to form a 5-14 membered ring;

wherein:

R^(B) is substituted with the group: -L-R^(D)

wherein:

L is a covalent bond or a divalent C₁₋₁₀ hydrocarbon chain, wherein one, two or three methylene units of L are optionally and independently replaced with one or more —O—, —S—, —NR^(B8)—, —(C═NR^(B8))—, —C(═O)—, —C(═S)—, —S(═O)—, —S(═O)₂—, divalent carbocyclyl, divalent heterocyclyl, divalent aryl or divalent heteroaryl group;

R^(D) is selected from —CN, —NO₂, —N₃, —SO₂H, —SO₃H, —C(═O)R^(B7), —CO₂H, —CHO, —C(OR^(B9))₂, —CO₂R^(B7), —OC(═O)R^(B7), —OCO₂R^(B7), —C(═O)N(R^(B8))₂, —OC(═O)N(R^(B8))₂, —NR^(B8)C(═O)R^(B7), —NR^(B8)CO₂R^(B7), —NR^(B8)C(═O)N(R^(B8))₂, —C(═NR^(B8))OR^(B7), —OC(═NR^(B8))R^(B7), —OC(═NR^(B8))OR^(B7), —C(═NR^(B8))N(R^(B8))₂, —OC(═NR^(B8))N(R^(B8))₂, —NR^(B8)C(═NR^(B8))N(R^(B8))₂, —C(═O)NR^(B8)SO₂R^(B7), —NR^(B8)SO₂R^(B7), —SO₂N(R^(B8))₂, —SO₂R^(B7), —SO₂OR^(B7), —OSO₂R^(B7), —S(═O)R^(B7), —OS(═O)R^(B7), —C(═S)N(R^(B8))₂, —C(═O)SR^(B7), —C(═S)SR^(B7), —SC(═S)SR^(B7), —P(═O)₂R^(B7), —OP(═O)₂R^(B7), —P(═O)(R^(B7))₂, —OP(═O)(R^(B7))₂, —OP(═O)(OR^(B9))₂, —P(═O)₂N(R^(B8))₂, —OP(═O)₂N(R^(B8))₂, —P(═O)(NR^(B8))₂, —OP(═O)(NR^(B8))₂, —NR^(B8)P(═O)(OR^(B9))₂, —NR^(B8)P(═O)(NR^(B8))₂, —B(OR^(B9))₂, —BR^(B7)(OR^(B9)), and tetrazolyl;

each instance of R^(B7) is, independently, selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl;

each instance of R^(B8) is, independently, selected from hydrogen, —OH, —OR^(B7), —N(R^(B9))₂, —CN, —C(═O)R^(B7), —C(═O)N(R^(B9))₂, —CO₂R^(B7), —SO₂R^(B7), —C(═NR^(B9))OR^(B7), —C(═NR^(B9))N(R^(B9))₂, —SO₂N(R^(B9))₂, —SO₂R^(B9), —SO₂OR^(B9), —SOR^(B7), —C(═S)N(R^(B9))₂, —C(═O)SR^(B9), —C(═S)SR^(B9), —P(═O)₂R^(B7), —P(═O)(R^(B7))₂, —P(═O)₂N(R^(B9))₂, —P(═O)(NR^(B9))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(B8) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring; and

each instance of R^(B9) is, independently, selected from hydrogen, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(B9) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring.

In one embodiment, provided herein is a compound of formula (I):

or a pharmaceutically acceptable form thereof;

wherein:

R^(A) is selected from C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl and 5-14 membered heteroaryl;

R^(B) is selected from C₁₋₁₀ alkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl and 5-14 membered heteroaryl;

R^(C) is selected from hydrogen, —OH, —OR^(C1), —ON(R^(C2))₂, —N(R^(C2))₂, —C(═O)R^(C1), —CHO, —CO₂R^(C1), —C(═O)N(R^(C2))₂, —C(═NR^(C2))OR^(C1), —C(═NR^(C2))N(R^(C2))₂, —SO₂R^(C1), —S(═O)R^(C1), —Si(R^(C1))₃, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl;

each instance of R^(C1) is, independently, selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl; and

each instance of R^(C2) is, independently, selected from hydrogen, —OH, —OR^(C1), —N(R^(C3))₂, —CN, —C(═O)R^(C1), —C(═O)N(R^(C3))₂, —CO₂R^(C1), —SO₂R^(C1), —C(═NR^(C3))OR^(C1), —C(═NR^(C3))N(R^(C3))₂, —SO₂N(R^(C3))₂, —SO₂R^(C3), —SO₂OR^(C3), —SOR^(C1), —C(═S)N(R^(C3))₂, —C(═O)SR^(C3), —C(═S)SR^(C3), —P(═O)₂R^(C1), —P(═O)(R^(C1))₂, —P(═O)₂N(R^(C3))₂, —P(═O)(NR^(C3))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(C2) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring;

or R^(B) and R^(C) together with the nitrogen (N) atom to which each is attached are joined to form a 5-14 membered ring.

Group R^(A)

As described generally above, R^(A) is selected from C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl.

In certain embodiments, R^(A) is C₃₋₁₀ carbocyclyl. Exemplary carbocyclyl groups include, but are not limited to, cyclopropyl (C₃), cyclobutyl (C₄), cyclopentyl (C₅), cyclopentenyl (C₅), cyclohexyl (C₆), cyclohexenyl (C₆), cyclohexadienyl (C₆), cycloheptyl (C₇), cycloheptadienyl (C₇), cycloheptatrienyl (C₇) and cyclooctyl (C₈).

In certain embodiments, R^(A) is 3-14 membered heterocyclyl. Exemplary heterocyclyl groups include, but are not limited to, azirdinyl, oxiranyl, thiorenyl, azetidinyl, oxetanyl, thietanyl, tetrahydrofuranyl, dihydrofuranyl, tetrahydrothiophenyl, dihydrothiophenyl, pyrrolidinyl, dihydropyrrolyl, dioxolanyl, oxathiolanyl, dithiolanyl, piperidinyl, tetrahydropyranyl, dihydropyridinyl, thianyl, piperazinyl, morpholinyl, dithianyl, dioxanyl, azepanyl, oxepanyl thiepanyl, azocanyl, oxecanyl and thiocanyl.

In certain embodiments, R^(A) is C₆₋₁₄ aryl. Exemplary aryl groups include, but are not limited to, phenyl, naphthyl and anthracyl. In certain embodiments, R^(A) is phenyl (C₆ aryl). In certain embodiments, R^(A) is naphthyl (C₁₀ aryl).

In certain embodiments, R^(A) is 5-14 membered heteroaryl. In certain embodiments, R^(A) is 5-10 membered heteroaryl. In certain embodiments, R^(A) is 5-6 membered heteroaryl. In certain embodiments, R^(A) is 5,6-bicyclic heteroaryl. In certain embodiments, R^(A) is 6,6-bicyclic heteroaryl.

In certain embodiments, R^(A) is a 5-membered heteroaryl group. Exemplary 5-membered heteroaryl groups include, but are not limited to, pyrrolyl, furanyl, thiophenyl, imidazolyl, pyrazolyl, oxazolyl, isoxazolyl, thiazolyl, isothiazolyl, triazolyl, oxadiazolyl, thiadiazolyl and tetrazolyl.

In certain embodiments, R^(A) is a 6-membered heteroaryl group. Exemplary 6-membered heteroaryl groups include, but are not limited to, pyridinyl, pyridazinyl, pyrimidinyl, pyrazinyl, triazinyl and tetrazinyl.

In certain embodiments, R^(A) is a 5,6-bicyclic heteroaryl group. Exemplary 5,6-bicyclic heteroaryl groups include, but are not limited to, indolyl, isoindolyl, indazolyl, benztriazolyl, benzothiophenyl, isobenzothiophenyl, benzofuranyl, benzoisofuranyl, benzimidazolyl, benzoxazolyl, benzisoxazolyl, benzoxadiazolyl, benzthiazolyl, benzisothiazolyl, benzthiadiazolyl, indolizinyl, and purinyl.

In certain embodiments, R^(A) is a 6,6-bicyclic heteroaryl group. Exemplary 6,6-bicyclic heteroaryl groups include, but are not limited to, naphthyridinyl, pteridinyl, quinolinyl, isoquinolinyl, cinnolinyl, quinoxalinyl, phthalazinyl and quinazolinyl.

In certain embodiments, R^(A) is a group of the formula (i):

wherein each group W—R¹, W—R², W—R³, W—R⁴, and W—R⁵ independently represents either a nitrogen atom (N) or C—R¹, C—R², C—R³, C—R⁴, or C—R⁵, respectively; and

wherein R¹, R², R³, R⁴ and R⁵ are independently selected from the group consisting of hydrogen, halogen, —CN, —NO₂, —N₃, —SO₂H, —SO₃H, —OH, —OR^(A1), —ON(R^(A2))₂, —N(R^(A2))₂, —N(OR^(A3))R^(A3), —SH, —SR^(A1), —SSR^(A3), —C(═O)R^(A1), —CO₂H, —CHO, —C(OR^(A3))₂, —CO₂R^(A1), —OC(═O)R^(A1), —OCO₂R^(A1), —C(O)N(R^(A2))₂, —OC(═O)N(R^(A2))₂, —NR^(A2)C(═O)R^(A1), —NR^(A2)CO₂R^(A1), —NR^(A2)C(═O)N(R^(A2))₂, —C(═NR^(A2))OR^(A1), —OC(═NR^(A2))R^(A1), —OC(═NR^(A2))OR^(A1), —C(═NR^(A2))N(R^(A2))₂, —OC(═NR^(A2))N(R^(A2))₂, —NR^(A2)C(═NR^(A2))N(R^(A2))₂, —C(═O)NR^(A2)SO₂R^(A1), —NR^(A2)SO₂R^(A1), —SO₂N(R^(A2))₂, —SO₂R^(A1), —SO₂OR^(A1), —OSO₂R^(A1), —S(═O)R^(A1), —OS(═O)R^(A1), —Si(R^(A1))₃, —OSi(R^(A1))₃, —C(═S)N(R^(A2))₂, —C(═O)SR^(A1), —C(═S)SR^(A1), —SC(═S)SR^(A1), —P(═O)₂R^(A1), —OP(═O)₂R^(A1), —P(═O)(R^(A1))₂, —OP(═O)(R^(A1))₂, —OP(═O)(OR^(A3))₂, —P(═O)₂N(R^(A2))₂, —OP(═O)₂N(R^(A2))₂, —P(═O)(NR^(A2))₂, —OP(═O)(NR^(A2))₂, —NR^(A2)P(═O)(OR^(A3))₂, —NR^(A2)P(═O)(NR^(A2))₂, —P(R^(A3))₂, —P(R^(A3))₃, —OP(R^(A3))₂, —OP(R^(A3))₃, —B(OR^(A3))₂, —BR^(A1)(OR^(A3)), C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl; or one or more of R¹ and R², R² and R³, R³ and R⁴ or R⁴ and R⁵ are joined to form a C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl or 5-14 membered heteroaryl ring;

each instance of R^(A1) is, independently, selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl;

each instance of R^(A2) is, independently, selected from hydrogen, —OH, —OR^(A1), —N(R^(A3))₂, —CN, —C(═O)R^(A1), —C(═O)N(R^(A3))₂, —CO₂R^(A1), —SO₂R^(A1), —C(═NR^(A3))OR^(A1), —C(═NR^(A3))N(R^(A3))₂, —SO₂N(R^(A3))₂, —SO₂R^(A3), —SO₂OR^(A3), —SOR^(A1), —C(═S)N(R^(A3))₂, —C(═O)SR^(A3), —C(═S)SR^(A3), —P(═O)₂R^(A1), —P(═O)(R^(A1))₂, —P(═O)₂N(R^(A3))₂, —P(═O)(NR^(A3))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(A2) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring; and

each instance of R^(A3) is, independently, selected from hydrogen, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(A3) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring.

In certain embodiments, the group of formula (i) represents a C₆₋₁₄ aryl group or a 6-14 membered heteroaryl group. In certain embodiments, the group of formula (i) represents a 6-14 membered heteroaryl group. In certain embodiments, the group of formula (i) represents a C₆₋₁₄ aryl group. In certain embodiments, the C₆₋₁₄ aryl group of formula (i) represents a phenyl group.

As used herein, when one or more of R¹, R², R³, R⁴ and R⁵ is referred to as “not hydrogen”, it is meant that one or more of R¹, R², R³, R⁴ and R⁵ is independently selected from a group consisting of halogen, —CN, —NO₂, —N₃, —SO₂H, —SO₃H, —OH, —OR^(A1), —ON(R^(A2))₂, —N(R^(A2))₂, —N(OR^(A3))R^(A3), —SH, —SR^(A1), —SSR^(A3), —C(═O)R^(A1), —CO₂H, —CHO, —C(OR^(A3))₂, —CO₂R^(A1), —OC(═O)R^(A1), —OCO₂R^(A1), —C(═O)N(R^(A2))₂, —OC(═O)N(R^(A2))₂, —NR^(A2)C(═O)R^(A1), —NR^(A2)CO₂R^(A1), —NR^(A2)C(═O)N(R^(A2))₂, —C(═NR^(A2))OR^(A1), —OC(═NR^(A2))R^(A1), —OC(═NR^(A2))OR^(A1), —C(═NR^(A2))N(R^(A2))₂, —OC(═NR^(A2))N(R^(A2))₂, —NR^(A2)C(═NR^(A2))N(R^(A2))₂, —C(═O)NR^(A2)SO₂R^(A1), —NR^(A2)SO₂R^(A1), —SO₂N(R^(A2))₂, —SO₂R^(A1), —SO₂OR^(A1), —OSO₂R^(A1), —S(═O)R^(A1), —OS(═O)R^(A1), —Si(R^(A1))₃, —OSi(R^(A1))₃, —C(═S)N(R^(A2))₂, —C(═O)SR^(A1), —C(═S)SR^(A1), —SC(S)SR^(A1), —P(═O)₂R^(A1), —OP(═O)₂R^(A1), —P(═O)(R^(A1))₂, —OP(═O)(R^(A1))₂, —OP(═O)(OR^(A3))₂, —P(═O)₂N(R^(A2))₂, —OP(═O)₂N(R^(A2))₂, —P(═O)(NR^(A2))₂, —OP(═O)(NR^(A2))₂, —NR^(A2)P(═O)(OR^(A3))₂, —NR^(A2)P(═O)(NR^(A2))₂, —P(R^(A3))₂, —P(R^(A3))₃, —OP(R^(A3))₂, —OP(R^(A3))₃, —B(OR^(A3))₂, or —BR^(A1)(OR^(A3)), C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl; or one or more of R¹ and R², R² and R³, R³ and R⁴ or R⁴ and R⁵ are joined to form a C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl or 5-14 membered heteroaryl ring.

In certain embodiments, R¹, R², R³, R⁴ and R⁵ are independently selected from the group consisting of hydrogen, halogen, —CN, —NO₂, —SO₂H, —SO₃H, —OH, —OR^(A1), —N(R^(A2))₂, —C(═O)R^(A1), —CO₂H, —CHO, —C(OR^(A3))₂, —CO₂R^(A1), —OC(═O)R^(A1), —OCO₂R^(A1), —C(═O)N(R^(A2))₂, —OC(═O)N(R^(A2))₂, —NR^(A2)C(═O)R^(A1), —NR^(A2)CO₂R^(A1), —NR^(A2)C(═O)N(R^(A2))₂, —C(═NR^(A2))OR^(A1), —OC(═NR^(A2))R^(A1), —OC(═NR^(A2))OR^(A1), —C(═NR^(A2))N(R^(A2))₂, —OC(═NR^(A2))N(R^(A2))₂, —NR^(A2)C(═NR^(A2))N(R^(A2))₂, —C(═O)NR^(A2)SO₂R^(A1), —NR^(A2)SO₂R^(A1), —SO₂N(R^(A2))₂, —SO₂R^(A1), —SO₂OR^(A1), —OSO₂R^(A1), —S(═O)R^(A1), —OS(═O)R^(A1), C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl; or one or more of R¹ and R², R² and R³, R³ and R⁴ or R⁴ and R⁵ are joined to form a C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl or 5-14 membered heteroaryl ring.

In certain embodiments, R¹, R², R³, R⁴ and R⁵ are independently selected from the group consisting of hydrogen, halogen, —CN, —OR^(A1), —N(R^(A2))₂, —CO₂H, —CO₂R^(A1), —C(═O)N(R^(A2))₂, —SO₂R^(A1), C₁₋₁₀ alkyl, C₂₋₁₀ alkynyl, 3-14 membered heterocyclyl, and C₆₋₁₄ aryl; or one or more of R¹ and R², R² and R³, R³ and R⁴ or R⁴ and R⁵ are joined to form a 5-14 membered heteroaryl ring.

In certain embodiments, R¹, R², R³, R⁴ and R⁵ are independently selected from the group consisting of hydrogen, halogen, —OR^(A1), —N(R^(A2))₂, —CO₂H, —C(═O)N(R^(A2))₂, —SO₂R^(A1), and 3-14 membered heterocyclyl; or R⁴ and R⁵ are joined to form a 5-14 membered heteroaryl ring.

In certain embodiments, R¹, R², R³, R⁴ and R⁵ are independently selected from the group consisting of hydrogen, halogen, —OR^(A1), and —C(═O)N(R^(A2))₂; or R⁴ and R⁵ are joined to form a 5-14 membered heteroaryl ring.

In certain embodiments, R¹, R², R³, R⁴ and R⁵ are independently selected from the group consisting of hydrogen, halogen, —OR^(A1), and —C(═O)N(R^(A2))₂; or R⁴ and R⁵ are joined to form a 5-14 membered heteroaryl ring.

In certain embodiments, R¹, R², R³, R⁴ and R⁵ are independently selected from the group consisting of hydrogen, halogen, and —OR^(A1). In certain embodiments, R¹, R², R³, R⁴ and R⁵ are independently selected from the group consisting of hydrogen, fluoro, chloro, and —OR^(A1). In certain embodiments, R¹, R², R³, R⁴ and R⁵ are independently selected from the group consisting of hydrogen, fluoro, chloro, and —OMe. In certain embodiments, R¹, R², R³, R⁴ and R⁵ are independently selected from the group consisting of hydrogen, fluoro and —OR^(A1). In certain embodiments, R¹, R², R³, R⁴ and R⁵ are independently selected from the group consisting of hydrogen, fluoro and —OMe. In certain embodiments, R¹, R², R³, R⁴ and R⁵ are independently selected from the group consisting of hydrogen and fluoro. In certain embodiments, R¹, R², R³, R⁴ and R⁵ are independently selected from the group consisting of hydrogen and chloro.

In certain embodiments, R⁴ and R⁵ are joined to form a 5-14 membered heteroaryl ring.

In certain embodiments, R^(A) is a group of the formula (ii):

wherein R¹, R², R³, R⁴ and R⁵ are as defined above and herein.

In certain embodiments, the group of formula (ii) represents a C₆₋₁₄ aryl group. In certain embodiments, the C₆₋₁₄ aryl group of formula (ii) represents a phenyl group.

In certain embodiments, R^(A) is a monosubstituted, disubstituted or trisubstituted group of the formula (ii). In certain embodiments, R^(A) is a monosubstituted or disubstituted group of the formula (ii).

In certain embodiments, R^(A) is a monosubstituted group of the formula (ii).

For example, in certain embodiments, R^(A) is an ortho-substituted group of the formula (ii), e.g., wherein R¹-R⁴ are hydrogen, and R⁵ is not hydrogen, e.g., of the formula (ii-a).

In certain embodiments, R^(A) is a meta-substituted group of the formula (ii), e.g., wherein R¹-R³ and R⁵ are hydrogen and R⁴ is not hydrogen, e.g., of the formula (ii-b).

In certain embodiments, R^(A) is a para-substituted group of the formula (ii), e.g., wherein R¹, R², R⁴ and R⁵ are hydrogen and R³ is not hydrogen, e.g., of the formula (ii-c).

In certain embodiments, R^(A) is a disubstituted group of the formula (ii).

For example, in certain embodiments, R^(A) is a 2,6-disubstituted group of the formula (ii), e.g., wherein R², R³ and R⁴ are hydrogen, and R¹ and R⁵ are not hydrogen, e.g., of the formula (ii-d).

In certain embodiments, R^(A) is a 2,5-disubstituted group of the formula (ii), e.g., wherein R², R³ and R⁵ are hydrogen, and R¹ and R⁴ are not hydrogen, e.g., of the formula (ii-e).

In certain embodiments, R^(A) is a 2,4-disubstituted group of the formula (ii), e.g., wherein R², R³ and R⁵ are hydrogen, and R¹ and R³ are not hydrogen, e.g., of the formula (ii-f).

In certain embodiments, R^(A) is a 2,3-disubstituted group of the formula (ii), e.g., wherein R¹, R² and R³ are hydrogen, and R⁴ and R⁵ are not hydrogen, e.g., of the formula (ii-g).

In certain embodiments, R^(A) is a 3,4-disubstituted group of the formula (ii), e.g., wherein R¹, R⁴ and R⁵ are hydrogen, and R² and R³ are not hydrogen, e.g., of the formula (ii-h).

In certain embodiments, R^(A) is a 3,5-disubstituted group of the formula (ii), e.g., wherein R¹, R³ and R⁵ are hydrogen, and R² and R⁴ are not hydrogen, e.g., of the formula (ii-i).

For example, in certain embodiments, R^(A) is a 2,6-disubstituted group as described herein, e.g., of the formula (ii-d):

wherein R¹ and R⁵ are as defined above and herein.

In certain embodiments, one of R¹ and R⁵ is halogen, —CN, —OR^(A1), —N(R^(A2))₂, —CO₂H, —CO₂R^(A1), —C(═O)N(R^(A2))₂, —SO₂R^(A1), C₁₋₁₀ alkyl, C₂₋₁₀ alkynyl, 3-14 membered heterocyclyl, and C₆₋₁₄ aryl, and the other of R¹ and R⁵ is halogen, —CN, —OR^(A1), —N(R^(A2))₂, —CO₂H, —CO₂R^(A1), —C(═O)N(R^(A2))₂, —SO₂R^(A1), C₁₋₁₀ alkyl, C₂₋₁₀ alkynyl, 3-14 membered heterocyclyl, and C₆₋₁₄ aryl.

In certain embodiments, one of R¹ and R⁵ is halogen, —OR^(A1), C₁₋₁₀ alkyl, or —C(═O)N(R^(A2))₂, and the other of R¹ and R⁵ is halogen, —OR^(A1), C₁₋₁₀ alkyl, or —C(═O)N(R^(A2))₂.

In certain embodiments, each of R¹ and R⁵ is independently halogen. For example, each of R¹ and R⁵ is independently selected from fluoro and chloro.

In certain embodiments, R^(A) is a trisubstituted group of the formula (ii).

For example, in certain embodiments, R^(A) is a 2,4,6-trisubstituted group of the formula (ii), e.g., wherein R² and R⁴ are hydrogen, and R¹, R³ and R⁵ are not hydrogen, e.g., of the formula (ii-j).

In certain embodiments, R^(A) is a 2,3,6-trisubstituted group of the formula (ii), e.g., wherein R² and R³ are hydrogen, and R¹, R⁴ and R⁵ are not hydrogen, e.g., of the formula (ii-k).

In certain embodiments, R^(A) is a 2,4,5-trisubstituted group of the formula (ii), e.g., wherein R² and R⁵ are hydrogen, and R¹, R³ and R⁴ are not hydrogen, e.g., of the formula (ii-1).

In certain embodiments, R^(A) is a 2,3,4-trisubstituted group of the formula (ii), e.g., wherein R⁴ and R⁵ are hydrogen, and R¹, R² and R³ are not hydrogen, e.g., of the formula (ii-m).

In certain embodiments, R^(A) is a 3,4,5-trisubstituted group of the formula (ii), e.g., wherein R¹ and R⁵ are hydrogen, and R², R³ and R⁴ are not hydrogen, e.g., of the formula (ii-n).

In certain embodiments, R^(A) is heteroaryl selected from a 5-6-membered heteroaryl, a 5,6-bicyclic heteroaryl or a 6,6-bicyclic heteroaryl.

In certain embodiments, R^(A) is a 6-membered heteroaryl. In certain embodiments, R^(A) is a 6-membered heteroaryl selected from pyridinyl. In certain embodiments, R^(A) is 2-pyridinyl, 3-pyridinyl or 4-pyridinyl.

In certain embodiments, R^(A) is a 2-pyridinyl wherein W—R¹ is N, and W—R², W—R³, W—R⁴, and W—R⁵ are C—R², C—R³, C—R⁴ and C—R⁵, respectively, e.g., of the formula (iii).

In certain embodiments, R^(A) is a 3-pyridinyl wherein W—R² is N, and W—R¹, W—R³, W—R⁴, and W—R⁵ are C—R¹, C—R³, C—R⁴ and C—R⁵, respectively, e.g., of the formula (iv).

In certain embodiments, R^(A) is a 4-pyridinyl wherein W—R³ is N, and W—R¹, W—R², W—R⁴, and W—R⁵ are C—R¹, C—R², C—R⁴ and C—R⁵, respectively, e.g., of the formula (v).

wherein R¹, R², R³, R⁴ and R⁵ are as defined above and herein.

In certain embodiments, R^(A) is a monosubstituted or disubstituted pyridinyl.

In certain embodiments, R^(A) is a monosubstituted pyridinyl.

In certain embodiments, R^(A) is a monosubstituted pyridinyl of the formula (iii) wherein R³, R⁴, R⁵ are hydrogen and R² is not hydrogen, e.g., of the formula (iii-a).

In certain embodiments, R^(A) is a monosubstituted pyridinyl of the formula (iii) wherein R², R⁴, R⁵ are hydrogen and R³ is not hydrogen, e.g., of the formula (iii-b).

In certain embodiments, R^(A) is a monosubstituted pyridinyl of the formula (iii) wherein R², R³, R⁵ are hydrogen and R⁴ is not hydrogen, e.g., of the formula (iii-c).

In certain embodiments, R^(A) is a monosubstituted pyridinyl of the formula (iii) wherein R², R³, R⁴ are hydrogen and R⁵ is not hydrogen, e.g., of the formula (iii-d).

In certain embodiments, R^(A) is a monosubstituted pyridinyl of the formula (iv) wherein R³, R⁴, R⁵ are hydrogen and R¹ is not hydrogen, e.g., of the formula (iv-a).

In certain embodiments, R^(A) is a monosubstituted pyridinyl of the formula (iv) wherein R¹, R⁴, R⁵ are hydrogen and R³ is not hydrogen, e.g., of the formula (iv-b).

In certain embodiments, R^(A) is a monosubstituted pyridinyl of the formula (iv) wherein R¹, R³, R⁵ are hydrogen and R⁴ is not hydrogen, e.g., of the formula (iv-c).

In certain embodiments, R^(A) is a monosubstituted pyridinyl of the formula (iv) wherein R¹, R³, R⁴ are hydrogen and R⁵ is not hydrogen, e.g., of the formula (iv-d).

In certain embodiments, R^(A) is a monosubstituted pyridinyl of the formula (v) wherein R², R⁴, R⁵ are hydrogen and R¹ is not hydrogen, e.g., of the formula (v-a).

In certain embodiments, R^(A) is a monosubstituted pyridinyl of the formula (v) wherein R¹, R⁴, R⁵ are hydrogen and R² is not hydrogen, e.g., of the formula (v-b).

In certain embodiments, R^(A) is a disubstituted pyridinyl.

In certain embodiments, R^(A) is a disubstituted pyridinyl of the formula (iii) wherein R³ and R⁴ are hydrogen and R² and R⁵ are not hydrogen, e.g., of the formula (iii-e).

In certain embodiments, R^(A) is a disubstituted pyridinyl of the formula (iii) wherein R² and R⁴ are hydrogen and R³ and R⁵ are not hydrogen, e.g., of the formula (iii-f).

In certain embodiments, R^(A) is a disubstituted pyridinyl of the formula (iii) wherein R² and R³ are hydrogen and R⁴ and R⁵ are not hydrogen, e.g., of the formula (iii-g).

In certain embodiments, R^(A) is a disubstituted pyridinyl of the formula (iii) wherein R³ and R⁵ are hydrogen and R² and R⁴ are not hydrogen, e.g., of the formula (iii-h).

In certain embodiments, R^(A) is a disubstituted pyridinyl of the formula (iii) wherein R⁴ and R⁵ are hydrogen and R² and R³ are not hydrogen, e.g., of the formula (iii-i).

In certain embodiments, R^(A) is a disubstituted pyridinyl of the formula (iii) wherein R² and R⁵ are hydrogen and R³ and R⁴ are not hydrogen, e.g., of the formula (iii-j).

In certain embodiments, R^(A) is a disubstituted pyridinyl of the formula (iv) wherein R³ and R⁴ are hydrogen and R¹ and R⁵ are not hydrogen, e.g., of the formula (iv-e).

In certain embodiments, R^(A) is a disubstituted pyridinyl of the formula (iv) wherein R³ and R⁵ are hydrogen and R¹ and R⁴ are not hydrogen, e.g., of the formula (iv-f).

In certain embodiments, R^(A) is a disubstituted pyridinyl of the formula (iv) wherein R⁴ and R⁵ are hydrogen and R¹ and R³ are not hydrogen, e.g., of the formula (iv-g).

In certain embodiments, R^(A) is a disubstituted pyridinyl of the formula (iv) wherein R¹ and R⁴ are hydrogen and R³ and R⁵ are not hydrogen, e.g., of the formula (iv-h).

In certain embodiments, R^(A) is a disubstituted pyridinyl of the formula (iv) wherein R¹ and R⁵ are hydrogen and R³ and R⁴ are not hydrogen, e.g., of the formula (iv-i).

In certain embodiments, R^(A) is a disubstituted pyridinyl of the formula (iv) wherein R¹ and R³ are hydrogen and R⁴ and R⁵ are not hydrogen, e.g., of the formula (iv-j).

In certain embodiments, R^(A) is a disubstituted pyridinyl of the formula (v) wherein R² and R⁴ are hydrogen and R¹ and R⁵ are not hydrogen, e.g., of the formula (v-c).

In certain embodiments, R^(A) is a disubstituted pyridinyl of the formula (v) wherein R⁴ and R⁵ are hydrogen and R¹ and R² are not hydrogen, e.g., of the formula (v-d).

In certain embodiments, R^(A) is a disubstituted pyridinyl of the formula (v) wherein R² and R⁵ are hydrogen and R¹ and R⁴ are not hydrogen, e.g., of the formula (v-e).

In certain embodiments, R^(A) is a disubstituted pyridinyl of the formula (v) wherein R¹ and R⁵ are hydrogen and R² and R⁴ are not hydrogen, e.g., of the formula (v-f).

In certain embodiments, R^(A) is a 5,6-bicyclic heteroaryl.

For example, in certain embodiments, R^(A) is a 5,6-bicyclic heteroaryl group of the formula (vi) (which is a subset of a group of the formula (ii-g)):

wherein R¹, R², R³ are as defined above and herein and R⁴ and R⁵ are joined to form a 5-membered heteroaryl ring;

X, Y and Z are independently selected from CR^(A4), O, S, N, or NR^(A5);

each instance of R^(A4) is, independently, selected from hydrogen, halogen, —CN, —NO₂, —N₃, —SO₂H, —SO₃H, —OH, —OR^(A6), —ON(R^(A7))₂, —N(R^(A7))₂, —N(OR^(A6))R^(A8), —SH, —SR^(A6), —SSR^(A8), —C(═O)R^(A6), —CO₂H, —CHO, —C(OR^(A8))₂, —CO₂R^(A6), —OC(═O)R^(A6), —OCO₂R^(A6), —C(═O)N(R^(A7))₂, —OC(═O)N(R^(A7))₂, —NR^(A7)C(═O)R^(A6), —NR^(A7)CO₂R^(A6), —NR^(A7)C(═O)N(R^(A7))₂, —C(═NR^(A7))OR^(A6), —OC(═NR^(A7))R^(A6), —OC(═NR^(A7))OR^(A6), —C(═NR^(A7))N(R^(A7))₂, —OC(═NR^(A7))N(R^(A7))₂, —NR^(A7)C(═NR^(A7))N(R^(A7))₂, —C(═O)NR^(A7)SO₂R^(A6), —NR^(A7)SO₂R^(A6), —SO₂N(R^(A7))₂, —SO₂R^(A6), —SO₂ORA⁶, —OSO₂R^(A6), —S(═O)R^(A6), —OS(═O)R^(A6), —Si(R^(A6))₃, —OSi(R^(A6))₃, —C(═S)N(R^(A7))₂, —C(═O)SR^(A6), —C(═S)SR^(A6), —SC(═S)SR^(A6), —P(═O)₂R^(A6), —OP(═O)₂R^(A6), —P(═O)(R^(A6))₂, —OP(═O)(R^(A6))₂, —OP(═O)(OR^(A8))₂, —P(═O)₂N(R^(A7))₂, —OP(═O)₂N(R^(A7))₂, —P(═O)(NR^(A7))₂, —OP(═O)(NR^(A7))₂, —NR^(A7)P(═O)(OR^(A8))₂, —NR^(A7)P(═O)(NR^(A7))₂, —P(R^(A8))₂, —P(R^(A8))₃, —OP(R^(A8))₂, —OP(R^(A8))₃, —B(OR^(A8))₂, or —BR^(A6)(OR^(A8)), C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl;

each instance of R^(A6) is, independently, selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl;

each instance of R^(A5) and R^(A7) is, independently, selected from hydrogen, —OH, —OR^(A6), —N(R^(A7))₂, —CN, —C(═O)R^(A6), —C(═O)N(R^(A7))₂, —CO₂R^(A6), —SO₂R^(A7), —C(═NR^(A3))OR^(A6), —C(═NR^(A7))N(R^(A7))₂, —SO₂N(R^(A3))₂, —SO₂R^(A6), —SO₂OR^(A8), —SOR^(A6), —C(═S)N(R^(A7))₂, —C(═O)SR^(A8), —C(═S)SR^(A8), —P(═O)₂R^(A6), —P(═O)(R^(A6))₂, —P(═O)₂N(R^(A8))₂, —P(═O)(NR^(A8))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(A7) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring;

each instance of R^(A8) is, independently, selected from hydrogen, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(A8) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring; and

the dashed line represents a double or single bond.

In certain embodiments, R¹ is hydrogen. In certain embodiments, R² is hydrogen. In certain embodiments, R³ is hydrogen. In certain embodiments, R¹, R² and R³ are hydrogen.

In certain embodiments, R^(A) is a heteroaryl group of the formulae (vi-a) or (vi-b):

wherein R¹, R², R³ are as defined above and X and Z are independently selected from O, S and NR^(A5).

In certain embodiments, wherein R^(A) is a heteroaryl group of the formulae (vi-a) or (vi-b), X and Z are O (i.e., benzoxazolyl). In certain embodiments, X and Z are S (i.e., benzthiazolyl). In certain embodiments, X and Z are NR^(A5) (i.e., imidazolyl).

In certain embodiments, R^(A) is a heteroaryl group of the formulae (vi-c) or (vi-d):

wherein R¹, R², R³ are as defined above and X is independently selected from O, S and NR^(A5).

In certain embodiments, wherein R^(A) is a heteroaryl group of the formulae (vi-c) or (vi-d), X is O (i.e., benzisoxazolyl). In certain embodiments, X is S (i.e., benzisothiazolyl). In certain embodiments, X is NR^(A5) (i.e., indazolyl).

In certain embodiments, R^(A) is a heteroaryl group of the formulae (vi-e), (vi-f) or (vi-g):

wherein R¹, R², R³ and R^(A4) are as defined above and X, Y and Z are independently selected from O, S and NR^(A5).

In certain embodiments, wherein R^(A) is a heteroaryl group of the formulae (vi-e), (vi-f) or (vi-g), Y is O (i.e., benzofuranyl or isobenzofuranyl). In certain embodiments, Y is S (i.e., benzothiophenyl or isobenzothiophenyl). In certain embodiments, Y is NR^(A5) (i.e., indolyl or isoindolyl).

In certain embodiments, R^(A) is a heteroaryl group of the formula (vi-h):

wherein R¹, R², R³ are as defined above and Y is independently selected from O, S and NR^(A5).

In certain embodiments, wherein R^(A) is a heteroaryl group of the formula (vi-e), Y is O (i.e., benzoxadiazolyl). In certain embodiments, Y is S (i.e., benzthiadiazolyl). In certain embodiments, Y is NR^(A5) (i.e., benztriazolyl).

Group R^(B)

As described generally above, R^(B) is selected from C₁₋₁₀ alkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl and 5-14 membered heteroaryl; or R^(B) and R^(C) together with the nitrogen (N) atom to which each is attached are joined to form a 5-14 membered ring.

In certain embodiments, R^(B) is selected from C₁₋₁₀ alkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl and 5-14 membered heteroaryl.

In certain embodiments, R_(B) is an acyclic group, i.e., selected from C₁₋₁₀ alkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl and 3-14 membered heteroaliphatic. In certain embodiments, R^(B) is C₁₋₁₀ alkyl. In certain embodiments, R^(B) is a substituted C₁₋₁₀ alkyl, e.g., a C₁₋₁₀ aralkyl group. In certain embodiments, R^(B) is a C₁₋₂ aralkyl, e.g., for example, a substituted or unsubstituted benzyl group (C₁ aralkyl) or substituted or unsubstituted phenylethyl group (C₂ aralkyl). In certain embodiments, R^(B) is a C₁₋₁₀ heteroaralkyl. In certain embodiments, R^(B) is alkenyl. In certain embodiments, R^(B) is alkynyl. In certain embodiments, R^(B) is 3-14 membered heteroaliphatic.

Alternatively, in certain embodiments, R^(B) is a cyclic group, i.e., selected from C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl and 5-14 membered heteroaryl.

In certain embodiments, R^(B) is C₃₋₁₀ carbocyclyl or 3-14 membered heterocyclyl.

In certain embodiments, R^(B) is C₃₋₁₀ carbocyclyl. Exemplary carbocyclyl groups include, but are not limited to, cyclopropyl (C₃), cyclobutyl (C₄), cyclopentyl (C₅), cyclopentenyl (C₅), cyclohexyl (C₆), cyclohexenyl (C₆), cyclohexadienyl (C₆), cycloheptyl (C₇), cycloheptadienyl (C₇), cycloheptatrienyl (C₇) and cyclooctyl (C₈).

In certain embodiments, R^(B) is 3-14 membered heterocyclyl. Exemplary heterocyclyl groups include, but are not limited to, azirdinyl, oxiranyl, thiorenyl, azetidinyl, oxetanyl, thietanyl, tetrahydrofuranyl, dihydrofuranyl, tetrahydrothiophenyl, dihydrothiophenyl, pyrrolidinyl, dihydropyrrolyl, dioxolanyl, oxathiolanyl, dithiolanyl, piperidinyl, tetrahydropyranyl, dihydropyridinyl, thianyl, piperazinyl, morpholinyl, dithianyl, dioxanyl, azepanyl, oxepanyl thiepanyl, azocanyl, oxecanyl and thiocanyl.

In certain embodiments, R^(B) is C₆₋₁₄ aryl or 5-14 membered heteroaryl.

In certain embodiments, R^(B) is C₆₋₁₄ aryl. Exemplary aryl groups include, but are not limited to, phenyl, naphthyl and anthracyl. In certain embodiments, R^(B) is phenyl (C₆ aryl). In certain embodiments, R^(B) is naphthyl (C₁₀ aryl).

In certain embodiments, R^(B) is 5-14 membered heteroaryl. In certain embodiments, R^(B) is 5-10 membered heteroaryl. In certain embodiments, R^(B) is 5-6 membered heteroaryl. In certain embodiments, R^(B) is a 5,6-bicyclic heteroaryl. In certain embodiments, R^(B) is a 6,6-bicyclic heteroaryl.

In certain embodiments, R^(B) is a 5-membered heteroaryl group. Exemplary 5-membered heteroaryl groups include, but are not limited to, pyrrolyl, furanyl, thiophenyl, imidazolyl, pyrazolyl, oxazolyl, isoxazolyl, thiazolyl, isothiazolyl, triazolyl, oxadiazolyl, thiadiazolyl and tetrazolyl.

In certain embodiments, R^(B) is a 6-membered heteroaryl group. Exemplary 6-membered heteroaryl groups include, but are not limited to, pyridinyl, pyridazinyl, pyrimidinyl, pyrazinyl, triazinyl and tetrazinyl.

In certain embodiments, R^(B) is a 5,6-bicyclic heteroaryl group. Exemplary 5,6-bicyclic heteroaryl groups include, but are not limited to, indolyl, isoindolyl, indazolyl, benztriazolyl, benzothiophenyl, isobenzothiophenyl, benzofuranyl, benzoisofuranyl, benzimidazolyl, benzoxazolyl, benzisoxazolyl, benzoxadiazolyl, benzthiazolyl, benzisothiazolyl, benzthiadiazolyl, indolizinyl, and purinyl.

In certain embodiments, R^(B) is a 6,6-bicyclic heteroaryl group. Exemplary 6,6-bicyclic heteroaryl groups include, but are not limited to, naphthyridinyl, pteridinyl, quinolinyl, isoquinolinyl, cinnolinyl, quinoxalinyl, phthalazinyl and quinazolinyl.

In certain embodiments, R^(B) is substituted with the group: -L-R^(D)

wherein:

L is a covalent bond or a divalent C₁₋₁₀ hydrocarbon chain, wherein one, two or three methylene units of L are optionally and independently replaced with one or more —O—, —S—, —NR^(B8)—, —(C═NR^(B8))—, —C(═O)—, —C(═S)—, —S(═O)—, —S(═O)₂—, divalent C₃₋₁₀ carbocyclyl, divalent 3-14 membered heterocyclyl, divalent C₆₋₁₄ aryl or divalent 5-14 membered heteroaryl group; and

R^(D) is selected from —CN, —NO₂, —N₃, —SO₂H, —SO₃H, —C(═O)R^(B7), —CO₂H, —CHO, —C(OR^(B9))₂, —CO₂R^(B7), —OC(═O)R^(B7), —OCO₂R^(B7), —C(═O)N(R^(B8))₂, —OC(═O)N(R^(B8))₂, —NR^(B8)C(═O)R^(B7), —NR^(B8)CO₂R^(B7), —NR^(B8)C(═O)N(R^(B8))₂, —C(═NR^(B8))OR^(B7), —OC(═NR^(B8))R^(B7), —OC(═NR^(B8))OR^(B7), —C(═NR^(B8))N(R^(B8))₂, —OC(═NR^(B8))N(R^(B8))₂, —NR^(B8)C(═NR^(B8))N(R^(B8))₂, —C(═O)NR^(B8)SO₂R^(B7), —NR^(B8)SO₂R^(B7), —SO₂N(R^(B8))₂, —SO₂R^(B7), —SO₂OR^(B7), —OSO₂R^(B7), —S(═O)R^(B7), —OS(═O)R^(B7), —C(═S)N(R^(B8))₂, —C(═O)SR^(B7), —C(═S)SR^(B7), —SC(═S)SR^(B7), —P(═O)₂R^(B7), —OP(═O)₂R^(B7), —P(═O)(R^(B7))₂, —OP(═O)(R^(B7))₂, —OP(═O)(OR^(B9))₂, —P(═O)₂N(R^(B8))₂, —OP(═O)₂N(R^(B8))₂, —P(═O)(NR^(B8))₂, —OP(═O)(NR^(B8))₂, —NR^(B8)P(═O)(OR^(B9))₂, —NR^(B8)P(═O)(NR^(B8))₂, —B(OR^(B9))₂, —BR^(B7)(OR^(B9)), and tetrazolyl;

each instance of R^(B7) is, independently, selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl;

each instance of R^(B8) is, independently, selected from hydrogen, —OH, —OR^(B7), —N(R^(B9))₂, —CN, —C(═O)R^(B7), —C(═O)N(R^(B9))₂, —CO₂R^(B7), —SO₂R^(B7), —C(═NR^(B9))OR^(B7), —C(═NR^(B9))N(R^(B9))₂, —SO₂N(R^(B9))₂, —SO₂R^(B9), —SO₂OR^(B9), —SOR^(B7), —C(═S)N(R^(B9))₂, —C(═O)SR^(B9), —C(═S)SR^(B9), —P(═O)₂R^(B7), —P(═O)(R^(B7))₂, —P(═O)₂N(R^(B9))₂, —P(═O)(NR^(B9))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(B8) groups are joined to form a 3-14 membered heterocyclyl or a 5-14 membered heteroaryl ring; and

each instance of R^(B9) is, independently, selected from hydrogen, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(B9) groups are joined to form a 3-14 membered heterocyclyl or a 5-14 membered heteroaryl ring.

In certain embodiments, L is a covalent bond.

In certain embodiments, L is a divalent C₁₋₁₀ hydrocarbon chain, wherein one, two or three methylene units of L are optionally and independently replaced with one or more —O—, —S—, —NR^(B8)—, —(C═NR^(B8))—, —C(═O)—, —C(═S)—, —S(═O)—, —S(═O)₂—, divalent carbocyclyl, divalent heterocyclyl, divalent aryl or divalent heteroaryl group.

In certain embodiments, L is a divalent C₁₋₁₀ hydrocarbon chain, wherein one, two or three methylene units of L are optionally and independently replaced with one or more —O—, —S—, —NR^(B8)—, —(C═NR^(B8))—, —C(═O)—, —C(═S)—, —S(═O)—, —S(═O)₂—, divalent C₃₋₁₀ carbocyclyl, divalent 3-14 membered heterocyclyl, divalent C₆₋₁₄ aryl or divalent 5-14 membered heteroaryl group.

As generally described above, R^(D) is selected from the group consisting of —CN, —NO₂, —SO₂H, —SO₃H, —C(═O)R^(B7), —CO₂H, —CHO, —C(OR^(B9))₂, —CO₂R^(B7), —OC(═O)R^(B7), —OCO₂R^(B7), —C(═O)N(R^(B8))₂, —OC(═O)N(R^(B8))₂, —NR^(B8)C(═O)R^(B7), —NR^(B8)CO₂R^(B7), —NR^(B8)C(═O)N(R^(B8))₂, —C(═NR^(B8))OR^(B7), —OC(═NR^(B8))R^(B7), —OC(═NR^(B8))OR^(B7), —C(═NR^(B8))N(R^(B8))₂, —OC(═NR^(B8))N(R^(B8))₂, —NR^(B8)C(═NR^(B8))N(R^(B8))₂, —C(═O)NR^(B8)SO₂R^(B7), —NR^(B8)SO₂R^(B7), —SO₂N(R^(B8))₂, —SO₂R^(B7), —SO₂OR^(B7), —OSO₂R^(B7), —S(═O)R^(B7), —OS(═O)R^(B7), —C(═S)N(R^(B8))₂, —C(═O)SR^(B7), —C(═S)SR^(B7), —SC(═S)SR^(B7), —P(═O)₂R^(B7), —OP(═O)₂R^(B7), —P(═O)(R^(B7))₂, —OP(═O)(R^(B7))₂, —OP(═O)(OR^(B9))₂, —P(═O)₂N(R^(B8))₂, —OP(═O)₂N(R^(B8))₂, —P(═O)(NR^(B8))₂, —OP(═O)(NR^(B8))₂, —NR^(B8)P(═O)(OR^(B9))₂, —NR^(B8)P(═O)(NR^(B8))₂, —B(OR^(B9))₂, —BR^(B7)(OR^(B9)) and tetrazolyl.

However, in certain embodiments, R^(D) is not —CO₂R^(B7) (e.g., CO₂Me, CO₂Et, CO₂nPr, CO₂iPr, or CO₂tBu), but can be selected from any of the other substituents listed above. In certain embodiments, R^(D) is not —C(═O)R^(B7)), but can be selected from any of the other substituents listed above. In certain embodiments, R^(D) is not —CHO), but can be selected from any of the other substituents listed above. In certain embodiments, R^(D) is not —C(OR^(B9))₂), but can be selected from any of the other substituents listed above. In certain embodiments, R^(D) is not —CN), but can be selected from any of the other substituents listed above. In certain embodiments, R^(D) is not —NO₂), but can be selected from any of the other substituents listed above. In certain embodiments, R^(D) is not any one of —SO₂H, —SO₃H, —SO₂N(R^(B8))₂, —NR^(B8)SO₂R^(B7), —SO₂R^(B7), —SO₂OR^(B7), —OSO₂R^(B7), —S(═O)R^(B7) or —OS(═O)R^(B7)), but can be selected from any of the other substituents listed above. In certain embodiments, R^(D) is not any one of —OC(═O)R^(B7), —OCO₂R^(B7), —OC(═O)N(R^(B8))₂, —NR^(B8)C(═O)R^(B7), —NR^(B8)CO₂R^(B7), —NR^(B8)C(═O)N(R^(B8))₂, —OC(═NR^(B8))R^(B7), —OC(═NR^(B8))OR^(B7), —OC(═NR^(B8))N(R^(B8))₂ or —NR^(B8)C(═NR^(B8))N(R^(B8))₂), but can be selected from any of the other substituents listed above. In certain embodiments, R^(D) is not any one of —C(═S)N(R^(B8))₂, —C(═O)SR^(B7) ₅—C(═S)SR^(B7) or —SC(═S)SR^(B7)), but can be selected from any of the other substituents listed above. In certain embodiments, R^(D) is not any one of —P(═O)₂R^(B7), —OP(═O)₂R^(B7), —P(═O)(R^(B7))₂, —OP(═O)(R^(B7))₂, —OP(═O)(OR^(B9))₂, —P(═O)₂N(R^(B8))₂, —OP(═O)₂N(R^(B8))₂, —P(═O)(NR^(B8))₂, —OP(═O)(NR^(B8))₂, —NR^(B8)P(═O)(OR^(B9))₂ or —NR^(B8)P(═O)(NR^(B8))₂), but can be selected from any of the other substituents listed above. In certain embodiments, R^(D) is not any one of —B(OR^(B9))₂ or —BR^(B7)(OR^(B9))), but can be selected from any of the other substituents listed above. In certain embodiments, R^(D) is not tetrazolyl), but can be selected from any of the other substituents listed above.

In certain embodiments, R^(D) is selected from —CN, —NO₂, —SO₂H, —SO₃H, —C(═O)R^(B7) ₅—CO₂H, —CHO, —CO₂R^(B7) ₅—C(═O)N(R^(B8))₂, —C(═NR^(B8))OR^(B7) ₅—C(═NR^(B8))N(R^(B8))₂, —C(═O)NR^(B8)SO₂R^(B7) ₅—SO₂N(R^(B8))₂, —SO₂R^(B7) ₅—SO₂OR^(B7) ₅—S(═O)R^(B7) ₅—C(═S)N(R^(B8))₂, —C(═O)SR^(B7), —C(═S)SR^(B7), —P(═O)₂R^(B7), —P(═O)(R^(B7))₂, —P(═O)₂N(R^(B8))₂, —P(═O)(NR^(B8))₂, —B(OR^(B9))₂, —BR^(B7)(OR^(B9)) and tetrazolyl. In certain embodiments, L is a covalent bond.

In certain embodiments, R^(D) is selected from —C(═O)R^(B7), —CO₂H, —CHO, —CO₂R^(B7), —C(═O)N(R^(B8))₂, —C(═NR^(B8))OR^(B7), —C(═NR^(B8))N(R^(B8))₂, —C(═O)NR^(B8)SO₂R^(B7), —C(═S)N(R^(B8))₂, —C(═O)SR^(B7) and —C(═S)SR^(B7). In certain embodiments, L is a covalent bond.

In certain embodiments, R^(D) is selected from —C(═O)R^(B7), —CO₂H, —CHO, and —CO₂R^(B7). In certain embodiments, L is a covalent bond.

In certain embodiments, R^(D) is —CO₂H. In certain embodiments, L is a covalent bond.

In certain embodiments, wherein R^(B) is substituted with -L-R^(D), R^(B) is further substituted with the group: —R^(E)

wherein:

R^(E) is selected from halogen, —OH, —OR^(B10), —ON(R^(B11))₂, —N(R^(B11))₂, —N(OR^(B12))R^(B12), —SH, —SR^(B10), —SSR^(B12), —OC(═O)R^(B10), —OCO₂R^(B10), —OC(═O)N(R^(B11))₂, —NR^(B11)C(═O)R^(B10), —NR^(B11)CO₂R^(B10), —NR^(B11)C(═O)N(R^(B11))₂, —OC(═NR^(B11))R^(B10), —OC(═NR^(B11))OR^(B10), —OC(═NR^(B11))N(R^(B11))₂, —NR^(B11)C(═NR^(B11))N(R^(B11))₂, —NR^(B11)SO₂R^(B10), —OSO₂R^(B10), —OS(═O)R^(B10), —Si(R^(B10))₃, —OSi(R^(B10))₃, —SC(S)SR^(B10), —OP(═O)₂R^(B10), —OP(═O)(R^(B10))₂, —OP(═O)(OR^(B12))₂, —OP(═O)₂N(R^(B11))₂, —OP(═O)(NR^(B11))₂, —NR^(B11)P(═O)(OR^(B12))₂, —NR^(B11)P(═O)(NR^(B12))₂, —P(R^(B12))₂, —P(R^(B12))₃, —OP(R^(B12))₂, —OP(R^(B12))₃, 3-14 membered heterocyclyl and 5-14 membered heteroaryl, wherein the point of attachment of the 3-14 membered heterocyclyl or 5-14 membered heteroaryl group is on a nitrogen atom;

each instance of R^(B10) is, independently, selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl;

each instance of R^(B11) is, independently, selected from hydrogen, —OH, —OR^(B10), —N(R^(B12))₂, —CN, —C(═O)R^(B10), —C(═O)N(R^(B12))₂, —CO₂R^(B10), —SO₂R^(B10), —C(═NR^(B12))OR^(B10), —C(═NR^(B12))N(R^(B12))₂, —SO₂N(R^(B12))₂, —SO₂R^(B12), —SO₂OR^(B12), —SOR^(B10), —C(═S)N(R^(B12))₂, —C(═O)SR^(B12), —C(═S)SR^(B12), —P(═O)₂R^(B10), —P(═O)(R^(B10))₂, —P(═O)₂N(R^(B12))₂, —P(═O)(NR^(B12))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(B11) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring; and

each instance of R^(B12) is, independently, selected from hydrogen, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(B12) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring.

In certain embodiments, R^(E) is selected from halogen, —OH, —OR^(B10), —ON(R_(B11))₂, —N(R^(B11))₂, —N(OR^(B12))R^(B12), —SH, —SR^(B10), —SSR^(B12), —Si(R^(B10))₃, —OSi(R^(B10))₃, —P(R^(B12))₂, —P(R^(B12))₃, —OP(R^(B12))₂, —OP(R^(B12))₃, 3-14 membered heterocyclyl and 5-14 membered heteroaryl, wherein the point of attachment of the 3-14 membered heterocyclyl or 5-14 membered heteroaryl group is on a nitrogen atom.

In certain embodiments, R^(E) is selected from halogen, —OH, —OR^(B10), —N(R^(B11))₂, 3-14 membered heterocyclyl and 5-14 membered heteroaryl, wherein the point of attachment of the 3-14 membered heterocyclyl or 5-14 membered heteroaryl group is on a nitrogen atom.

In certain embodiments, R^(E) is selected from halogen, —OR^(B10) and —N(R^(B11))₂. In certain embodiments, R^(E) is halogen. In certain embodiments, R^(E) is —OR^(B10). In certain embodiments, R^(E) is —N(R^(B11))₂.

In certain embodiments, -L-R^(D) and —R^(E) are vicinal R^(B) substituents (i.e., attached to two adjacent atoms on the group R^(B); e.g., ortho to each other). In certain embodiments, -L-R^(D) and —R^(E) are ortho to each other.

In certain embodiments, -L-R^(D) and —R^(E) are not vicinal R^(B) substituents (i.e., not attached to two adjacent atoms on the group R^(B); e.g., meta or para to each other). In certain embodiments, -L-R^(D) and —R^(E) are meta to each other. In certain embodiments, -L-R^(D) and —R^(E) are para to each other.

In certain embodiments, the R^(B) is a group of the formula (vii):

wherein each group W—R⁶, W—R⁷, W—R⁸, W—R⁹, and W—R¹⁰ independently represents either a nitrogen atom (N) or C—R⁶, C—R⁷, C—R⁸, C—R⁹, or C—R¹⁰, respectively; and

wherein R⁶, R⁷, R⁸, R⁹ and R¹⁰ are independently selected from the group consisting of hydrogen, halogen, —CN, —NO₂, —N₃, —SO₂H, —SO₃H, —OH, —OR^(B1), —ON(R^(B2))₂, —N(R^(B2))₂, —N(OR^(B3))R^(B3), —SH, —SR^(B1), —SSR^(B3), —C(═O)R^(B1), —CO₂H, —CHO, —C(OR^(B3))₂, —CO₂R^(B1), —OC(═O)R^(B1), —OCO₂R^(B1), —C(═O)N(R^(B2))₂, —OC(═O)N(R^(B2))₂, —NR^(B2)C(═O)R^(B1), —NR^(B2)CO₂R^(B1), —NR^(B2)C(═O)N(R^(B2))₂, —C(═NR^(B2))OR^(B1), —OC(═NR^(B2))R^(B1), —OC(═NR^(B2))OR^(B1), —C(═NR^(B2))N(R^(B2))₂, —OC(═NR^(B2))N(R^(B2))₂, —NR^(B2)C(═NR^(B2))N(R^(B2))₂, —C(═O)NR^(B2)SO₂R^(B1), —NR^(B2)SO₂R^(B1), —SO₂N(R^(B2))₂, —SO₂R^(B1), —SO₂OR^(B1), —OSO₂R^(B1), —S(═O)R^(B1), —OS(═O)R^(B1), —Si(R^(B1))₃, —OSi(R^(B1))₃, —C(═S)N(R^(B2))₂, —C(═O)SR^(B1), —C(═S)SR^(B1), —SC(S)SR^(B1), —P(═O)₂R^(B1), —OP(═O)₂R^(B1), —P(═O)(R^(B1))₂, —OP(═O)(R^(B1))₂, —OP(═O)(OR^(B3))₂, —P(═O)₂N(R^(B2))₂, —OP(═O)₂N(R^(B2))₂, —P(═O)(NR^(B2))₂, —OP(═O)(NR^(B2))₂, —NR^(B2)P(═O)(OR^(B3))₂, —NR^(B2)P(═O)(NR^(B2))₂, —P(R^(B3))₂, —P(R^(B3))₃, —OP(R^(B3))₂, —OP(R^(B3))₃, —B(OR^(B3))₂, or —BR^(B1)(OR^(B3)), C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, 5-14 membered heteroaryl, -L-R^(D) and —R^(E); or one or more of R⁶ and R⁷, R⁷ and R⁸, R⁸ and R⁹ or R⁹ and R¹⁰ are joined to form a C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl or 5-14 membered heteroaryl ring; or R¹⁰ and R^(C) are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring;

each instance of R^(B1) is, independently, selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl;

each instance of R^(B2) is, independently, selected from hydrogen, —OH, —OR^(B1), —N(R^(B3))₂, —CN, —C(═O)R^(B1), —C(═O)N(R^(B3))₂, —CO₂R^(B1), —SO₂R^(B1), —C(═NR^(B3))OR^(B1), —C(═NR^(B3))N(R^(B3))₂, —SO₂N(R^(B3))₂, —SO₂R^(B3), —SO₂OR^(B3), —SOR^(B1), —C(═S)N(R^(B3))₂, —C(═O)SR^(B3), —C(═S)SR^(B3), —P(═O)₂R^(B1), —P(═O)(R^(B1))₂, —P(═O)₂N(R^(B3))₂, —P(═O)(NR^(B3))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(B2) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring;

each instance of R^(B3) is, independently, selected from hydrogen, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(B3) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring;

and L, R^(D) and R^(E) are as defined above and herein.

As used herein, when one or more of R⁶, R⁷, R⁸, R⁹ and R¹⁰ is referred to as “not hydrogen”, it is meant that one or more of R⁶, R⁷, R⁸, R⁹ and R¹⁰ is independently selected from the group consisting of halogen, —CN, —NO₂, —N₃, —SO₂H, —SO₃H, —OH, —OR^(B1), —ON(R^(B2))₂, —N(R^(B2))₂, —N(OR^(B3))R^(B3), —SH, —SR^(B1), —SSR^(B3), —C(═O)R^(B1), —CO₂H, —CHO, —C(OR^(B3))₂, —CO₂R^(B1), —OC(═O)R^(B1), —OCO₂R^(B1), —C(═O)N(R^(B2))₂, —OC(═O)N(R^(B2))₂, —NR^(B2)C(═O)R^(B1), —NR^(B2)CO₂R^(B1), —NR^(B2)C(═O)N(R^(B2))₂, —C(═NR^(B2))OR^(B1), —OC(═NR^(B2))R^(B1), —OC(═NR^(B2))OR^(B1), —C(═NR^(B2))N(R^(B2))₂, —OC(═NR^(B2))N(R^(B2))₂, —NR^(B2)C(═NR^(B2))N(R^(B2))₂, —C(═O)NR^(B2)SO₂R^(B1), —NR^(B2)SO₂R^(B1), —SO₂N(R^(B2))₂, —SO₂R^(B1), —SO₂OR^(B1), —OSO₂R^(B1), —S(═O)R^(B1), —OS(═O)R^(B1), —Si(R^(B1))₃, —OSi(R^(B1))₃, —C(═S)N(R^(B2))₂, —C(═O)SR^(B1), —C(═S)SR^(B1), —SC(═S)SR^(B1), —P(═O)₂R^(B1), —OP(═O)₂R^(B1), —P(═O)(R^(B1))₂, —OP(═O)(R^(B1))₂, —OP(═O)(OR^(B3))₂, —P(═O)₂N(R^(B2))₂, —OP(═O)₂N(R^(B2))₂, —P(═O)(NR^(B2))₂, —OP(═O)(NR^(B2))₂, —NR^(B2)P(═O)(OR^(B3))₂, —NR^(B2)P(═O)(NR^(B2))₂, —P(R^(B3))₂, —P(R^(B3))₃, —OP(R^(B3))₂, —OP(R^(B3))₃, —B(OR^(B3))₂, —BR^(B1)(OR^(B3)), -L-R^(D), —R^(E), C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl; or wherein one or more of R⁶ and R⁷, R⁷ and R⁸, R⁸ and R⁹ or R⁹ and R¹⁰ are joined to form a C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl or 5-14 membered heteroaryl ring, or wherein R¹⁰ and R^(C) are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring.

In certain embodiments, at least one of R⁶, R⁷, R⁸, R⁹, and R¹⁰ is the group -L-R^(D) as defined above and herein. In certain embodiments, at least one of R⁶, R⁷, R⁸, R⁹, and R¹⁰ is the group —R^(E) as defined herein.

In certain embodiments, the group of formula (vii) represents a C₆₋₁₄ aryl or a 6-14 membered heteroaryl group. In certain embodiments, the group of formula (vii) represents a 6-14 membered heteroaryl group. In certain embodiments, the group of formula (vii) represents a C₆₋₁₄ aryl group. In certain embodiments, the group of formula (vii) represents a phenyl group.

In certain embodiments, W—R⁶, W—R⁷, W—R⁸, W—R⁹, and W—R¹⁰ represent C—R⁶, C—R⁷, C—R⁸, C—R⁹, or C—R¹⁰, respectively. For example, in certain embodiments, R^(B) is a group of the formula (viii):

wherein R⁶, R⁷, R⁸, R⁹ and R¹⁰ are as defined above and herein.

In certain embodiments, at least one of R⁶, R⁷, R⁸, R⁹, and R¹⁰ is the group -L-R^(D) as defined above and herein. In certain embodiments, at least one of R⁶, R⁷, R⁸, R⁹, and R¹⁰ is the group —R^(E) as defined herein.

In certain embodiments, the group of the formula (viii) represents a C₆₋₁₄ aryl group. In certain embodiments, the C₆₋₁₄ aryl group of the formula (viii) represents a phenyl group.

In certain embodiments, R^(B) is a monosubstituted, disubstituted or trisubstituted group of the formula (viii). In certain embodiments, R^(B) is a monosubstituted or disubstituted group of the formula (viii).

In certain embodiments, R^(B) is a monosubstituted group of the formula (viii).

For example, in certain embodiments, R^(B) is an ortho-substituted group of formula (viii), e.g., wherein R⁶-R⁹ are hydrogen, and R¹⁰ is not hydrogen, e.g., of the formula (viii-a).

In certain embodiments, R^(B) is a meta-substituted group of the formula (viii), e.g., wherein R⁶-R⁸ and R¹⁰ are hydrogen and R⁹ is not hydrogen, e.g., of the formula (viii-b).

In certain embodiments, R^(B) is a para-substituted group of the formula (viii), e.g., wherein R⁶, R⁷, R⁹ and R¹⁰ are hydrogen and R⁸ is not hydrogen, e.g., of the formula (viii-c).

In certain embodiments, R^(B) is a disubstituted group of the formula (viii).

For example, in certain embodiments, R^(B) is a 2,6-disubstituted group of the formula (viii), e.g., wherein R⁷, R⁸ and R⁹ are hydrogen, and R⁶ and R¹⁰ are not hydrogen, e.g., of the formula (viii-d).

In certain embodiments, R^(B) is a 2,5-disubstituted group of the formula (viii), e.g., wherein R⁶, R⁸ and R⁹ are hydrogen, and R⁷ and R¹⁰ are not hydrogen, e.g., of the formula (viii-e).

In certain embodiments, R^(B) is a 2,4-disubstituted group of the formula (viii), e.g., wherein R⁶, R⁷ and R⁹ are hydrogen, and R⁸ and R¹⁰ are not hydrogen, e.g., of the formula (viii-f).

In certain embodiments, R^(B) is a 2,3-disubstituted group of formula (viii), e.g., wherein R⁶, R⁷ and R⁸ are hydrogen, and R⁹ and R¹⁰ are not hydrogen, e.g., of the formula (viii-g).

In certain embodiments, R^(B) is a 3,4-disubstituted group of the formula (viii), e.g., wherein R⁶, R⁷ and R¹⁰ are hydrogen, and R⁸ and R⁹ are not hydrogen, e.g., of the formula (viii-h).

In certain embodiments, R^(B) is a 3,5-disubstituted group of the formula (viii), e.g., wherein R⁶, R⁷ and R¹⁰ are hydrogen, and R⁷ and R⁹ are not hydrogen, e.g., of the formula (viii-i).

In certain embodiments, R^(B) is a trisubstituted group of the formula (viii).

For example, in certain embodiments, R^(B) is a 2,4,6-trisubstituted group of formula (viii), e.g., wherein R⁷ and R⁹ are hydrogen, and R⁶, R⁸ and R¹⁰ are not hydrogen, e.g., of the formula (viii-j).

In certain embodiments, R^(B) is a 2,3,6-trisubstituted group of the formula (viii), e.g., wherein R² and R³ are hydrogen, and R¹, R⁴ and R⁵ are not hydrogen, e.g., of the formula (viii-k).

In certain embodiments, R^(B) is a 2,4,5-trisubstituted group of the formula (viii), e.g., wherein R⁸ and R⁹ are hydrogen, and R⁶, R⁷ and R¹⁰ are not hydrogen, e.g., of the formula (viii-l).

In certain embodiments, R^(B) is a 2,3,4-trisubstituted group of the formula (viii), e.g., wherein R⁶ and R⁹ are hydrogen, and R⁷, R⁸ and R¹⁰ are not hydrogen, e.g., of the formula (viii-m).

In certain embodiments, R^(B) is a 3,4,5-trisubstituted group of the formula (viii), e.g., wherein R⁶ and R¹⁰ are hydrogen, and R⁷, R⁸ and R⁹ are not hydrogen, e.g., of the formula (viii-n).

In certain embodiments, R^(B) is heteroaryl selected from a 5-6-membered heteroaryl, a 5,6-bicyclic heteroaryl, or a 6,6-bicyclic heteroaryl.

In certain embodiments, R^(B) is a 6-membered heteroaryl. In certain embodiments, R^(A) is a 6-membered heteroaryl selected from pyridinyl. In certain embodiments, R^(B) is 2-pyridinyl, 3-pyridinyl or 4-pyridinyl.

In certain embodiments, R^(B) is a 2-pyridinyl wherein W—R⁶ is N, and W—R⁷, W—R⁸, W—R⁹, and W—R¹⁰ are C—R⁷, C—R⁸, C—R⁹ and C—R¹⁰, respectively, e.g., of the formula (ix).

In certain embodiments, R^(B) is a 3-pyridinyl wherein W—R⁷ is N, and W—R⁶, W—R⁸, W—R⁹, and W—R¹⁰ are C—R⁶, C—R⁸, C—R⁹ and C—R¹⁰, respectively, e.g., of the formula (x).

In certain embodiments, R^(B) is a 4-pyridinyl wherein W—R⁸ is N, and W—R⁶, W—R⁷, W—R⁹, and W—R¹⁰ are C—R⁶, C—R⁷, C—R⁹ and C—R¹⁰, respectively, e.g., of the formula (xi).

wherein R⁶, R⁷, R⁸, R⁹ and R¹⁰ are as defined above and herein.

In certain embodiments, at least one of R⁶, R⁷, R⁸, R⁹, and R¹⁰ is the group -L-R^(D) as defined above and herein. In certain embodiments, at least one of R⁶, R⁷, R⁸, R⁹, and R¹⁰ is the group —R^(E) as defined herein.

In certain embodiments, R^(B) is a monosubstituted or disubstituted pyridinyl.

In certain embodiments, R^(B) is a monosubstituted pyridinyl.

In certain embodiments, R^(B) is a monosubstituted pyridinyl of the formula (ix) wherein R⁸, R⁹, R¹⁰ are hydrogen and R⁷ is not hydrogen, e.g., of the formula (ix-a).

In certain embodiments, R^(B) is a monosubstituted pyridinyl of the formula (ix) wherein R⁷, R⁹, R¹⁰ are hydrogen and R⁸ is not hydrogen, e.g., of the formula (ix-b).

In certain embodiments, R^(B) is a monosubstituted pyridinyl of the formula (ix) wherein R⁷, R⁸, R¹⁰ are hydrogen and R⁹ is not hydrogen, e.g., of the formula (ix-c).

In certain embodiments, R^(B) is a monosubstituted pyridinyl of the formula (ix) wherein R⁷, R⁸, R⁹ are hydrogen and R¹⁰ is not hydrogen, e.g., of the formula (ix-d).

In certain embodiments, R^(B) is a monosubstituted pyridinyl of the formula (x) wherein R⁸, R⁹, R¹⁰ are hydrogen and R⁶ is not hydrogen, e.g., of the formula (x-a).

In certain embodiments, R^(B) is a monosubstituted pyridinyl of the formula (x) wherein R⁶, R⁹, R¹⁰ are hydrogen and R⁸ is not hydrogen, e.g., of the formula (x-b).

In certain embodiments, R^(B) is a monosubstituted pyridinyl of the formula (x) wherein R⁶, R⁸, R¹⁰ are hydrogen and R⁹ is not hydrogen, e.g., of the formula (x-c).

In certain embodiments, R^(B) is a monosubstituted pyridinyl of the formula (x) wherein R⁶, R⁸, R⁹ are hydrogen and R¹⁰ is not hydrogen, e.g., of the formula (x-d).

In certain embodiments, R^(B) is a monosubstituted pyridinyl of the formula (xi) wherein R⁶, R⁷, R⁹ are hydrogen and R¹⁰ is not hydrogen, e.g., of the formula (xi-a).

In certain embodiments, R^(B) is a monosubstituted pyridinyl of the formula (v) wherein R⁶, R⁷, R¹⁰ are hydrogen and R⁹ is not hydrogen, e.g., of the formula (xi-b).

In certain embodiments, R^(B) is a disubstituted pyridinyl.

In certain embodiments, R^(B) is a disubstituted pyridinyl of the formula (ix) wherein R⁸ and R⁹ are hydrogen and R⁷ and R¹⁰ are not hydrogen, e.g., of the formula (ix-e).

In certain embodiments, R^(B) is a disubstituted pyridinyl of the formula (ix) wherein R⁷ and R⁹ are hydrogen and R⁸ and R¹⁰ are not hydrogen, e.g., of the formula (ix-f).

In certain embodiments, R^(B) is a disubstituted pyridinyl of the formula (ix) wherein R⁷ and R⁸ are hydrogen and R⁹ and R¹⁰ are not hydrogen, e.g., of the formula (ix-g).

In certain embodiments, R^(B) is a disubstituted pyridinyl of the formula (ix) wherein R⁸ and R¹⁰ are hydrogen and R⁷ and R⁹ are not hydrogen, e.g., of the formula (ix-h).

In certain embodiments, R^(B) is a disubstituted pyridinyl of the formula (ix) wherein R⁹ and R¹⁰ are hydrogen and R⁷ and R⁸ are not hydrogen, e.g., of the formula (ix-i).

In certain embodiments, R^(B) is a disubstituted pyridinyl of the formula (ix) wherein R⁷ and R¹⁰ are hydrogen and R⁸ and R⁹ are not hydrogen, e.g., of the formula (ix-j).

In certain embodiments, R^(B) is a disubstituted pyridinyl of the formula (x) wherein R⁸ and R⁹ are hydrogen and R⁶ and R¹⁰ are not hydrogen, e.g., of the formula (x-e).

In certain embodiments, R^(B) is a disubstituted pyridinyl of the formula (x) wherein R⁸ and R¹⁰ are hydrogen and R⁶ and R⁹ are not hydrogen, e.g., of the formula (x-f).

In certain embodiments, R^(B) is a disubstituted pyridinyl of the formula (x) wherein R⁹ and R¹⁰ are hydrogen and R⁶ and R⁸ are not hydrogen, e.g., of the formula (x-g).

In certain embodiments, R^(B) is a disubstituted pyridinyl of the formula (x) wherein R⁶ and R⁹ are hydrogen and R⁸ and R¹⁰ are not hydrogen, e.g., of the formula (x-h).

In certain embodiments, R^(B) is a disubstituted pyridinyl of the formula (x) wherein R⁶ and R¹⁰ are hydrogen and R⁸ and R⁹ are not hydrogen, e.g., of the formula (x-i).

In certain embodiments, R^(B) is a disubstituted pyridinyl of the formula (x) wherein R⁶ and R⁸ are hydrogen and R⁹ and R¹⁰ are not hydrogen, e.g., of the formula (x-j).

In certain embodiments, R^(B) is a disubstituted pyridinyl of the formula (xi) wherein R⁷ and R⁹ are hydrogen and R⁶ and R¹⁰ are not hydrogen, e.g., of the formula (xi-c).

In certain embodiments, R^(B) is a disubstituted pyridinyl of the formula (xi) wherein R⁶ and R⁷ are hydrogen and R⁹ and R¹⁰ are not hydrogen, e.g., of the formula (xi-d).

In certain embodiments, R^(B) is a disubstituted pyridinyl of the formula (xi) wherein R⁶ and R⁸ are hydrogen and R⁷ and R¹⁰ are not hydrogen, e.g., of the formula (xi-e).

In certain embodiments, R^(B) is a disubstituted pyridinyl of the formula (xi) wherein R⁶ and R¹⁰ are hydrogen and R⁷ and R⁹ are not hydrogen, e.g., of the formula (xi-f).

In certain embodiments, R^(B) is C₅₋₁₀ carbocyclyl or 5-10 membered heterocyclyl of the formula (xii):

wherein:

X is N, NR³⁰, O, S or CR³¹R³²;

p is 0, 1 or 2;

each instance of R²¹, R²², R²³, R²⁴, R²⁵, R²⁶, R²⁷, R²⁸, R²⁹, R³¹ and R³² is independently selected from hydrogen, halogen, —CN, —NO₂, —N₃, —SO₂H, —SO₃H, —OH, —OR^(B1), —ON(R^(B2))₂, —N(R^(B2))₂, —N(OR^(B3))R^(B3), —SH, —SR^(B1), —SSR^(B3), —C(═O)R^(B1), —CO₂H, —CHO, —C(OR^(B3))₂, —CO₂R^(B1), —OC(═O)R^(B1), —OCO₂R^(B1), —C(═O)N(R^(B2))₂, —OC(═O)N(R^(B2))₂, —NR^(B2)C(═O)R^(B1), —NR^(B2)CO₂R^(B1), —NR^(B2)C(═O)N(R^(B2))₂, —C(═NR^(B2))OR^(B1), —OC(═NR^(B2))R^(B1), —OC(═NR^(B2))OR^(B1), —C(═NR^(B2))N(R^(B2))₂, —OC(═NR^(B2))N(R^(B2))₂, —NR^(B2)C(═NR^(B2))N(R^(B2)) ₂, —C(═O)NR^(B2)SO₂R^(B1), —NR^(B2)SO₂R^(B1), —SO₂N(R^(B2))₂, —SO₂R^(B1), —SO₂OR^(B1), —OSO₂R^(B1), —S(═O)R^(B1), —OS(═O)R^(B1), —Si(R^(B1))₃, —OSi(R^(B1))₃, —C(═S)N(R^(B2))₂, —C(═O)SR^(B1), —C(═S)SR^(B1), —C(═S)SR^(B1), —SC(═S)SR^(B1), —P(═O)₂R^(B1), —OP(═O)₂R^(B1), —P(═O)(R^(B1))₂, —OP(═O)(R^(B1))₂, —OP(═O)(OR^(B3))₂, —P(═O)₂N(R^(B2))₂, —OP(═O)₂N(R^(B2))₂, —P(═O)(NR^(B2))₂, —OP(═O)(NR^(B2))₂, —NR^(B2)P(═O)(OR^(B3))₂, —NR^(B2)P(═O)(NR^(B2))₂, —P(R^(B3))₂, —P(R^(B3))₃, —OP(R^(B3))₂, —OP(R^(B3))₃, —B(OR^(B3))₂, or —BR^(B1)(OR^(B3)), C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, 5-14 membered heteroaryl, -L-R^(D) and —R^(E); or one or more of R²⁹ and R²¹, R²² and R²³, R²⁴ and R³¹, R³² and R²⁵, R²⁶ and R²⁷, R²⁸ and R²⁹, or R²⁶ and R²⁹, are joined to form a double bond or a C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl or 5-14 membered heteroaryl ring; optionally wherein X is N, then N and R²³ or N and R²⁵ are joined to form a double bond;

R³⁰ is selected from hydrogen, —OH, —OR^(B1), —N(R^(B3))₂, —CN, —C(═O)R^(B1), —C(═O)N(R^(B3))₂, —CO₂R^(B1), —SO₂R^(B1), —C(═NR^(B3))OR^(B1), —C(═NR^(B3))N(R^(B3))₂, —SO₂N(R^(B3))₂, —SO₂R^(B3), —SO₂OR^(B3), —S(═O)R^(B1), —C(═S)N(R^(B3))₂, —C(═O)SR^(B3), —C(═S)SR^(B3), —P(═O)₂R^(B1), —P(═O)(R^(B1))₂, —P(═O)₂N(R^(B3))₂, —P(═O)(NR^(B3))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, optionally wherein R²⁴ and R³⁰ or R³⁰ and R²⁵ are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring;

wherein:

each instance of R^(B1) is, independently, selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl;

each instance of R^(B2) is, independently, selected from hydrogen, —OH, —OR^(B1), —N(R^(B3))₂, —CN, —C(═O)R^(B1), —C(═O)N(R^(B3))₂, —CO₂R^(B1), —SO₂R^(B1), —C(═NR^(B3))OR^(B1), —C(═NR^(B3))N(R^(B3))₂, —SO₂N(R^(B3))₂, —SO₂R^(B3), —SO₂OR^(B3), —SOR^(B1), —C(═S)N(R^(B3))₂, —C(═O)SR^(B3), —C(═S)SR^(B3), —P(═O)₂R^(B1), —P(═O)(R^(B1))₂, —P(═O)₂N(R^(B3))₂, —P(═O)(NR^(B3))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(B2) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring;

each instance of R^(B3) is, independently, selected from hydrogen, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(B3) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring;

and L, R^(D) and R^(E) are as defined above and herein.

In certain embodiments, at least one of R²¹, R²², R²³, R²⁴, R²⁵, R²⁶, R²⁷, R²⁸, R²⁹, R³⁰, R³¹, and R³² is the group -L-R^(D) as defined above and herein. In certain embodiments, at least one of R²¹, R²², R²³, R²⁴, R²⁵, R²⁶, R²⁷, R²⁸, R²⁹, R³⁰, R³¹, and R³² is selected from the group —R^(E) as defined herein.

In certain embodiments, p is 0. In certain embodiments, p is 1. In certain embodiments, p is 2.

In certain embodiments, X is N. In certain embodiments, X is NR³⁰. In certain embodiments, X is O. In certain embodiments, X is S. In certain embodiments, X is CR³¹R³².

In certain embodiments, R^(B) is C₅₋₁₀ carbocyclyl or 5-10 membered heterocyclyl of the formula (xiii):

wherein:

X is N, NR³⁰, O, S or CR³¹R³²;

p is 0, 1 or 2;

each instance of R²¹, R²², R²³, R²⁴, R²⁵, R²⁶, R²⁷, R²⁸, R²⁹, R³¹ and R³² is independently selected from hydrogen, halogen, —CN, —NO₂, —N₃, —SO₂H, —SO₃H, —OH, —OR^(B1), —ON(R^(B2))₂, —N(R^(B2))₂, —N(OR^(B3))R^(B3), —SH, —SR^(B1), —SSR^(B3), —C(═O)R^(B1), —CO₂H, —CHO, —C(OR^(B3))₂, —CO₂R^(B1), —OC(═O)R^(B1), —OCO₂R^(B1), —C(═O)N(R^(B2))₂, —OC(═O)N(R^(B2))₂, —NR^(B2)C(═O)R^(B1), —NR^(B2)CO₂R^(B1), —NR^(B2)C(═O)N(R^(B2))₂, —C(═NR^(B2))OR^(B1), —OC(═NR^(B2))R^(B1), —OC(═NR^(B2))OR^(B1), —C(═NR^(B2))N(R^(B2))₂, —OC(═NR^(B2))N(R^(B2))₂, —NR^(B2)C(═NR^(B2))N(R^(B2))₂, —C(═O)NR^(B2)SO₂R^(B1), —NR^(B2)SO₂R^(B1), —SO₂N(R^(B2))₂, —SO₂R^(B1), —SO₂OR^(B1), —OSO₂R^(B1), —S(═O)R^(B1), —OS(═O)R^(B1), —Si(R^(B1))₃, —OSi(R^(B1))₃, —C(═S)N(R^(B2))₂, —C(═O)SR^(B1), —C(═S)SR^(B1), —SC(═S)SR^(B1), —P(═O)₂R^(B1), —OP(═O)₂R^(B1), —P(═O)(R^(B1))₂, —OP(═O)(R^(B1))₂, —OP(═O)(OR^(B3))₂, —P(═O)₂N(R^(B2))₂, —OP(═O)₂N(R^(B2))₂, —P(═O)(NR^(B2))₂, —OP(═O)(NR^(B2))₂, —NR^(B2)P(═O)(OR^(B3))₂, —NR^(B2)P(═O)(NR^(B2))₂, —P(R^(B3))₂, —P(R^(B3))₃, —OP(R^(B3))₂, —OP(R^(B3))₃, —B(OR^(B3))₂, or —BR^(B1)(OR^(B3)), C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, 5-14 membered heteroaryl, -L-R^(D) and —R^(E); or one or more of R²⁹ and R²¹, R²² and R³¹, R³² and R²³, R²⁴ and R²⁵, R²⁶ and R²⁷, R²⁸ and R²⁹, and R²⁶ and R²⁹, are joined to form a double bond or a C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl or 5-14 membered heteroaryl ring; optionally wherein X is N, then N and R²¹ or N and R²³ are joined to form a double bond;

R³⁰ is selected from hydrogen, —OH, —OR^(B1), —N(R^(B3))₂, —CN, —C(═O)R^(B1), —C(═O)N(R^(B3))₂, —CO₂R^(B1), —SO₂R^(B1), —C(═NR^(B3))OR^(B1), —C(═NR^(B3))N(R^(B3))₂, —SO₂N(R^(B3))₂, —SO₂R^(B3), —SO₂OR^(B3), —S(═O)R^(B1), —C(═S)N(R^(B3))₂, —C(═O)SR^(B3), —C(═S)SR^(B3), —P(═O)₂R^(B1), —P(═O)(R^(B1))₂, —P(═O)₂N(R^(B3))₂, —P(═O)(NR^(B3))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or R²² and R³⁰ or R³⁰ and R²³ are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring;

wherein:

each instance of R^(B1) is, independently, selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl;

each instance of R^(B2) is, independently, selected from hydrogen, —OH, —OR^(B1), —N(R^(B3))₂, —CN, —C(═O)R^(B1), —C(═O)N(R^(B3))₂, —CO₂R^(B1), —SO₂R^(B1), —C(═NR^(B3))OR^(B1), —C(═NR^(B3))N(R^(B3))₂, —SO₂N(R^(B3))₂, —SO₂R^(B3), —SO₂OR^(B3), —S(═O)R^(B1), —C(═S)N(R^(B3))₂, —C(═O)SR^(B3), —C(═S)SR^(B3), —P(═O)₂R^(B1), —P(═O)(R^(B1))₂, —P(═O)₂N(R^(B3))₂, —P(═O)(NR^(B3))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(B2) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring;

each instance of R^(B3) is, independently, selected from hydrogen, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(B3) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring;

and L, R^(D) and R^(E) are as defined above and herein.

In certain embodiments, at least one of R²¹, R²², R²³, R²⁴, R²⁵, R²⁶, R²⁷, R²⁸, R²⁹, R³⁰, R³¹, and R³² is the group -L-R^(D) as defined above and herein. In certain embodiments, at least one of at least one of R²¹, R²², R²³, R²⁴, R²⁵, R²⁶, R²⁷, R²⁸, R²⁹, R³⁰, R³¹, and R³² is selected from —R^(E) as defined herein.

In certain embodiments, p is 0. In certain embodiments, p is 1. In certain embodiments, p is 2.

In certain embodiments, X is N. In certain embodiments, X is NR³⁰. In certain embodiments, X is O. In certain embodiments, X is S. In certain embodiments, X is CR³¹R³².

For example, in certain embodiments, X is O. In certain embodiments, R^(B) is a 5-10 membered heterocyclyl of the formulae (xii-a) or (xiii-a):

wherein p, R²¹, R²², R²³, R²⁴, R²⁵, R²⁶, R²⁷, R²⁸ and R²⁹ are as defined above and herein.

In certain embodiments, X is NR³⁰. For example, in certain embodiments, R^(B) is heterocyclyl of the formulae (xii-b) or (xiii-b):

wherein p, R²¹, R²², R²³, R²⁴, R²⁵, R²⁶, R²⁷, R²⁸, R²⁹ and R³⁰ are as defined above and herein.

In certain embodiments, X is CR³¹R³². For example, in certain embodiments, R^(B) is C₅₋₁₀ carbocyclyl of the formula (xii-c):

wherein p, R²¹, R²², R²³, R²⁴, R²⁵, R²⁶, R²⁷, R²⁸, R²⁹, R³¹ and R³² are as defined above and herein.

Joined Groups R^(B) and R^(C)

As described generally above, in certain embodiments, R^(B) and R^(C) together with the nitrogen (N) atom to which each is attached are joined to form a 5-14 membered ring.

For example, in certain embodiments, R^(B) and R^(C) together with the nitrogen (N) atom to which each is attached are joined to form a 5-14 membered ring of the formula (xiv):

wherein:

Q is N, NR⁴⁰, O, S, or CR⁴¹R⁴²

m is 0, 1 or 2; and

each instance of R⁴¹, R⁴², R⁴³, R⁴⁴, R⁴⁵, R⁴⁶, R⁴⁷, R⁴⁸, R⁴⁹ and R⁵⁰ is independently selected from hydrogen, halogen, —CN, —NO₂, —N₃, —SO₂H, —SO₃H, —OH, —OR^(F1), —ON(R^(F2))₂, —N(R^(F2))₂, —N(OR^(F3))R^(F3), —SH, —SR^(F1), —SSR^(F3), —C(═O)R^(F1), —CO₂H, —CHO, —C(OR^(F3))₂, —CO₂R^(F1), OC(═O)R^(F1), —OCO₂R^(F1), —C(═O)N(R^(F2))₂, —OC(═O)N(R^(F2))₂, —NR^(F2)C(═O)R^(F1), —NR^(F2)CO₂R^(F1), —NR^(F2)C(═O)N(R^(F2))₂, —C(═NR^(F2))OR^(F1), —OC(═NR^(F2))R^(F1), —OC(═NR^(F2))OR^(F1), —C(═NR^(F2))N(R^(F2))₂, —OC(═NR^(F2))N(R^(F2))₂, —NR^(F2)C(═NR^(F2))N(R^(F2))₂, —C(═O)NR^(F2)SO₂R^(BC1), —NR^(F2)SO₂R^(F1), —SO₂N(R^(F2))₂, —SO₂R^(F1), —SO₂OR^(F1), —OSO₂R^(F1), —S(═O)R^(F1), —OS(═O)R^(F1), —Si(R^(F1))₃, —OSi(R^(F1))₃, —C(═S)N(R^(F2))₂, —C(═O)SR^(F1), —C(═S)SR^(F1), —SC(═S)SR^(F1), —P(═O)₂R^(F1), —OP(═O)₂R^(F1), —P(═O)(R^(F1))₂, —OP(═O)(R^(F1))₂, —OP(═O)(OR^(F3))₂, —P(═O)₂N(R^(F2))₂, —OP(═O)₂N(R^(F2))₂, —P(═O)(NR^(F2))₂, —OP(═O)(NR^(F2))₂, —NR^(F2)P(═O)(OR^(F3))₂, —NR^(F2)P(═O)(NR^(F2))₂, —P(R^(F3))₂, —P(R^(F3))₃, —OP(R^(F3))₂, —OP(R^(F3))₃, —B(OR^(F3))₂, or —BR^(F1)(OR^(F3)), C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, 5-14 membered heteroaryl, -L-R^(D) and —R^(E); or one or more of R⁴⁷ and R⁴⁹, R⁴⁸ and R⁵⁰, R⁴⁹ and R⁴¹, R⁵⁰ and R⁴², R⁴¹ and R⁴⁵, R⁴² and R⁴⁶, R⁴⁵ and R⁴³, and R⁴⁶ and R⁴⁴, are joined to form a double bond or a C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl or 5-14 membered heteroaryl ring; optionally wherein Q is N, then N and R⁴⁹ or N and R⁴⁶ are joined to form a double bond;

R⁴⁰ is selected from hydrogen, —OH, —OR^(F1), —N(R^(F3))₂, —CN, —C(═O)R^(F1), —C(═O)N(R^(F3))₂, —CO₂R^(F1), —SO₂R^(F1), —C(═NR^(F3))OR^(F1), —C(═NR^(F3))N(R^(F3))₂, —SO₂N(R^(F3))₂, —SO₂R^(F3), —SO₂OR^(F3), —SOR^(F1), —C(═S)N(R^(F3))₂, —C(═O)SR^(F3), —C(═S)SR^(F3), —P(═O)₂R^(F1), —P(═O)(R^(F1))₂, —P(═O)₂N(R^(F3))₂, —P(═O)(NR^(F3))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, optionally wherein R⁴⁹ and R⁴⁰ or R⁴⁰ and R⁴⁵ are joined to form a 3-14 membered heterocyclyl, or 5-14 membered heteroaryl ring;

wherein:

each instance of R^(F1) is, independently, selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl;

each instance of R^(F2) is, independently, selected from hydrogen, —OH, —OR^(F1), —N(R^(F3))₂, —CN, —C(═O)R^(F1), —C(═O)N(R^(F3))₂, —CO₂R^(F1), —SO₂R^(F1), —C(═NR^(F3))OR^(F1), —C(═NR^(F3))N(R^(F3))₂, —SO₂N(R^(F3))₂, —SO₂R^(F3), —SO₂OR^(F3), —S(═O)R^(F1), —C(═S)N(R^(F3))₂, —C(═O)SR^(F3), —C(═S)SR^(F3), —P(O)₂R^(F1), —P(═O)(R^(F1))₂, —P(═O)₂N(R^(F3))₂, —P(═O)(NR^(F3))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(F2) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring;

each instance of R^(F3) is, independently, selected from hydrogen, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(F3) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring;

and L, R^(D) and R^(E) are as defined above and herein.

In certain embodiments, at least one of R⁴⁰, R⁴¹, R⁴², R⁴³, R⁴⁴, R⁴⁵, R⁴⁶, R⁴⁷, R⁴⁸, R⁴⁹ and R⁵⁰ is the group -L-R^(D) as defined above and herein. In certain embodiments, at least one of R⁴⁰, R⁴¹, R⁴², R⁴³, R⁴⁴, R⁴⁵, R⁴⁶, R⁴⁷, R⁴⁸, R⁴⁹ and R⁵⁰ is selected from —R^(E) as defined herein.

In certain embodiments, m is 0. In certain embodiments, m is 1. In certain embodiments, m is 2.

In certain embodiments, Q is N. In certain embodiments, Q is NR⁴⁰. In certain embodiments, Q is O. In certain embodiments, Q is S. In certain embodiments, Q is CR⁴¹R⁴².

In certain embodiments, R⁴⁷ and R⁴⁹ are joined to form a double bond and R⁴⁸ and R⁵⁰ are joined to form a C₆₋₁₄ aryl or 5-14 membered heteroaryl. For example, in certain embodiments, R^(B) and R^(C) together with the nitrogen (N) atom to which each is attached are joined to form a 5-14 membered ring of the formula (xv):

wherein Q, m, W, R⁴¹, R⁴², R⁴³, R⁴⁴, R⁴⁵, R⁴⁶, R⁶, R⁷, R⁸ and R⁹ are as defined above and herein.

In certain embodiments, Q is CR⁴¹R⁴², R⁴⁹ and R⁴¹ are joined to form a double bond and R⁵⁰ and R⁴² are joined to form a C₆₋₁₄ aryl or 5-14 membered heteroaryl. For example, in certain embodiments, R^(B) and R^(C) together with the nitrogen (N) atom to which each is attached are joined to form a group of the formula (xvi):

wherein m, W, R⁴³, R⁴⁴, R⁴⁵, R⁴⁶, R⁴⁷ and R⁴⁸ are as defined above and herein; and

wherein R⁶⁶, R⁶⁷, R⁶⁸ and R⁶⁹ are independently selected from the group consisting of hydrogen, halogen, —CN, —NO₂, —N₃, —SO₂H, —SO₃H, —OH, —OR^(F4), —ON(R^(F5))₂, —N(R^(F5))₂, —N(OR^(F6))R^(F6), —SH, —SR^(F4), —SSR^(F6), —C(═O)R^(F4), —CO₂H, —CHO, —C(OR^(F6))₂, —CO₂R^(F4), —OC(═O)R^(F4), —OCO₂R^(F4), —C(═O)N(R^(F5))₂, —OC(═O)N(R^(F5))₂, —NR^(F5)C(═O)R^(F4), —NR^(F5)CO₂R^(F4), —NR^(F5)C(═O)N(R^(F5))₂, —C(═NR^(F5))OR^(F4), —OC(═NR^(F5))R^(F4), —OC(═NR^(F5))OR^(F4), —C(═NR^(F5))N(R^(F5))₂, —OC(═NR^(F5))N(R^(F5))₂, —NR^(F5)C(═NR^(F5))N(R^(F5))₂, —C(═O)NR^(F5)SO₂R^(F4), —NR^(F5)SO₂R^(F4), —SO₂N(R^(F5))₂, —SO₂R^(F4), —SO₂OR^(F4), —OSO₂R^(F4), —S(═O)R^(F4), —OS(═O)R^(F4), —Si(R^(F4))₃, —OSi(R^(F4))₃, —C(═S)N(R^(F5))₂, —C(═O)SR^(F4), —C(═S)SR^(F4), —SC(S)SR^(F4), —P(═O)₂R^(F4), —OP(═O)₂R^(F4), —P(═O)(R^(F4))₂, —OP(═O)(R^(F4))₂, —OP(═O)(OR^(F6))₂, —P(═O)₂N(R^(F5))₂, —OP(═O)₂N(R^(F5))₂, —P(═O)(NR^(F5))₂, —OP(═O)(NR^(F5))₂, —NR^(F5)P(═O)(OR^(F6))₂, —NR^(F5)P(═O)(NR^(F5))₂, —P(R^(F6))₂, —P(R^(F6))₃, —OP(R^(F6))₂, —OP(R^(F6))₃, —B(OR^(F6))₂, or —BR^(F4)(OR^(F6)), C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, 5-14 membered heteroaryl, -L-R^(D) and —R^(E); or one or more of R⁶⁶ and R⁶⁷, R⁶⁷ and R⁶⁸, and R⁶⁸ and R⁶⁹ are joined to form a C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl or 5-14 membered heteroaryl ring;

each instance of R^(F4) is, independently, selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl;

each instance of R^(F5) is, independently, selected from hydrogen, —OH, —OR^(F4), —N(R^(F6))₂, —CN, —C(═O)R^(F4), —C(═O)N(R^(F6))₂, —CO₂R^(F4), —SO₂R^(F4), —C(═NR^(F6))OR^(F4), —C(═NR^(F6))N(R^(F6))₂, —SO₂N(R^(F6))₂, —SO₂R^(F6), —SO₂OR^(F6), —SOR^(F4), —C(═S)N(R^(F6))₂, —C(═O)SR^(F6), —C(═S)SR^(F6), —P(═O)₂R^(F4), —P(═O)(R^(F4))₂, —P(═O)₂N(R^(F6))₂, —P(═O)(NR^(F6))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(F5) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring; and

each instance of R^(F6) is, independently, selected from hydrogen, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(F6) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring.

In certain embodiments, at least one of R⁴³, R⁴⁴, R⁴⁵, R⁴⁶, R⁴⁷, R⁴⁸, R⁶⁶, R⁶⁷, R⁶⁸ and R⁶⁹ is the group -L-R^(D) as defined above and herein. In certain embodiments, at least one of R⁴³, R⁴⁴, R⁴⁵, R⁴⁶, R⁴⁷, R⁴⁸, R⁶⁶, R⁶⁷, R⁶⁸ and R⁶⁹ is selected from —R^(E) as defined herein.

In certain embodiments, m is 0. In certain embodiments, m is 1. In certain embodiments, m is 2.

Group R^(C)

As described generally above, R^(C) is selected from hydrogen, —OH, —OR^(C1), —ON(R^(C2))₂, —N(R^(C2))₂, —C(═O)R^(C1), —CHO, —CO₂R^(C1), —C(═O)N(R^(C2))₂, —C(═NR^(C2))OR^(C1), —C(═NR^(C2))N(R^(C2))₂, —SO₂R^(C1), —S(═O)R^(C1), —Si(R^(C1))₃, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl;

wherein:

each instance of R^(C1) is, independently, selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl; and

each instance of R^(C2) is, independently, selected from hydrogen, —OH, —OR^(C1), —N(R^(C3))₂, —CN, —C(═O)R^(C1), —C(═O)N(R^(C3))₂, —CO₂R^(C1), —SO₂R^(C1), —C(═NR^(C3))OR^(C1), —C(═NR^(C3))N(R^(C3))₂, —SO₂N(R^(C3))₂, —SO₂R^(C3), —SO₂OR^(C3), —SOR^(C1), —C(═S)N(R^(C3))₂, —C(═O)SR^(C3), —C(═S)SR^(C3), —P(═O)₂R^(C1), —P(═O)(R^(C1))₂, —P(═O)₂N(R^(C3))₂, —P(═O)NR^(C3))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(C2) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring;

or R^(B) and R^(C) together with the nitrogen (N) atom to which each is attached are joined to form a 5-14 membered ring.

In certain embodiments, R^(C) is selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl.

In certain embodiments, R^(C) is an unsubstituted group, e.g., selected from unsubstituted C₁₋₁₀ alkyl, unsubstituted C₂₋₁₀ alkenyl, unsubstituted C₂₋₁₀ alkynyl, unsubstituted 3-14 membered heteroaliphatic, unsubstituted C₃₋₁₀ carbocyclyl, unsubstituted 3-14 membered heterocyclyl, unsubstituted C₆₋₁₄ aryl and unsubstituted 5-14 membered heteroaryl. However, in certain embodiments, R^(C) is an unsubstituted group wherein —CH₃ and —CH₂CH₃ are excluded.

In certain embodiments, R^(C) is a group having 2 or more carbon atoms, e.g., selected from C₂₋₁₀ alkyl, C₂₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl. In certain embodiments, R^(C) is an unsubstituted group having 2 or more carbon atoms. However, in certain embodiments, R^(C) is a group having 2 or more carbon atoms wherein —CH₂CH₃ is excluded.

In certain embodiments, R^(C) is a group having 3 or more carbon atoms, e.g., selected from C₃₋₁₀ alkyl, C₃₋₁₀ perhaloalkyl, C₃₋₁₀ alkenyl, C₃₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl. In certain embodiments, R^(C) is an unsubstituted group having 3 or more carbon atoms. However, in certain embodiments, R^(C) is a group having 3 or more carbon atoms wherein —CH(CH₃)₂ is excluded.

In certain embodiments, R^(C) is a group having 4 or more carbon atoms, e.g., selected from C₄₋₁₀ alkyl, C₄₋₁₀ perhaloalkyl, C₄₋₁₀ alkenyl, C₄₋₁₀ alkynyl, 5-14 membered heteroaliphatic, C₅₋₁₀ carbocyclyl, 5-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl. In certain embodiments, R^(C) is an unsubstituted group having 4 or more carbon atoms.

In certain embodiments, R^(C) is an acyclic group, e.g., selected from C₁₋₁₀ alkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl and 3-14 membered heteroaliphatic. In certain embodiments, R^(C) is an unsubstituted acyclic group, e.g., selected from unsubstituted C₁₋₁₀ alkyl, unsubstituted C₂₋₁₀ alkenyl, unsubstituted C₂₋₁₀ alkynyl and unsubstituted 3-14 membered heteroaliphatic. However, in certain embodiments, R^(C) is an acyclic group, wherein —CH₃ and —CH₂CH₃ are excluded.

In certain embodiments, R^(C) is C₁₋₁₀ alkyl. In certain embodiments, R^(C) is an unsubstituted C₁₋₁₀ alkyl. In certain embodiments, R^(C) is C₁₋₁₀ alkyl, wherein —CH₃ is excluded. In certain embodiments, R^(C) is C₁₋₁₀ alkyl, wherein —CH₂CH₃ is excluded. In certain embodiments, R^(C) is C₁₋₁₀ alkyl, wherein —CH(CH₃)₂ is excluded.

In certain embodiments, R^(C) is C₂₋₁₀ alkyl, e.g., selected from ethyl, n-propyl, isopropyl, n-butyl, tert-butyl, sec-butyl, iso-butyl, n-pentyl, pentan-3-yl, amyl, neopentyl, 3-methyl-2-butanyl, tertiary amyl and n-hexyl. In certain embodiments, R^(C) is an unsubstituted C₂₋₁₀ alkyl. In certain embodiments, R^(C) is C₂₋₁₀ alkyl, wherein —CH₂CH₃ is excluded. In certain embodiments, R^(C) is C₂₋₁₀ alkyl, wherein —CH(CH₃)₂ is excluded.

In certain embodiments, R^(C) is C₃₋₁₀ alkyl, e.g., selected from n-propyl, isopropyl, n-butyl, tert-butyl, sec-butyl, iso-butyl, n-pentyl, pentan-3-yl, amyl, neopentyl, 3-methyl-2-butanyl, tertiary amyl and n-hexyl. In certain embodiments, R^(C) is an unsubstituted C₃₋₁₀ alkyl. In certain embodiments, R^(C) is C₃₋₁₀ alkyl, wherein —CH(CH₃)₂ is excluded.

In certain embodiments, R^(C) is C₄₋₁₀ alkyl, e.g., selected from n-butyl, tert-butyl, sec-butyl, iso-butyl, n-pentyl, pentan-3-yl, amyl, neopentyl, 3-methyl-2-butanyl, tertiary amyl and n-hexyl. In certain embodiments, R^(C) is an unsubstituted C₄₋₁₀ alkyl.

In certain embodiments, R^(C) is C₂₋₁₀ alkenyl. In certain embodiments, R^(C) is an unsubstituted C₂₋₁₀ alkenyl. In certain embodiments, R^(C) is C₂₋₁₀ alkenyl selected from allyl.

In certain embodiments, R^(C) is C₂₋₁₀ alkynyl. In certain embodiments, R^(C) is an unsubstituted C₂₋₁₀ alkynyl.

In certain embodiments, R^(C) is 3-14 membered heteroaliphatic. In certain embodiments, R^(C) is an unsubstituted 3-14 membered heteroaliphatic.

In certain embodiments, R^(C) is a cyclic group, e.g., selected from C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl and 5-14 membered heteroaryl. In certain embodiments, R^(C) is an unsubstituted cyclic group, e.g., selected from unsubstituted C₃₋₁₀ carbocyclyl, unsubstituted 3-14 membered heterocyclyl, unsubstituted C₆₋₁₄ aryl and unsubstituted 5-14 membered heteroaryl.

In certain embodiments, R^(C) is C₃₋₁₀ carbocyclyl. In certain embodiments, R^(C) is C₄₋₁₀ carbocyclyl. In certain embodiments, R^(C) is C₅₋₁₀ carbocyclyl. In certain embodiments, R^(C) is C₅₋₈ carbocyclyl. In certain embodiments, R^(C) is C₃₋₁₀ carbocyclyl selected from cyclopropyl (C₃), cyclobutyl (C₄), cyclopentyl (C₅), cyclopentenyl (C₅), cyclohexyl (C₆), cyclohexenyl (C₆), cyclohexadienyl (C₆), cycloheptyl (C₇), cycloheptadienyl (C₇), cycloheptatrienyl (C₇) and cyclooctyl (C₈). In certain embodiments, R^(C) is C₃₋₁₀ carbocyclyl selected from cyclopentyl and cyclohexyl. In certain embodiments, R^(C) is an unsubstituted C₃₋₁₀ carbocyclyl.

In certain embodiments, R^(C) is 3-14 membered heterocyclyl. In certain embodiments, R^(C) is 5-10 membered heterocyclyl. In certain embodiments, R^(C) is 5-6 membered heterocyclyl. In certain embodiments, R^(C) is 3-14 membered heterocyclyl selected from azirdinyl, oxiranyl, thiorenyl, azetidinyl, oxetanyl, thietanyl, tetrahydrofuranyl, dihydrofuranyl, tetrahydrothiophenyl, dihydrothiophenyl, pyrrolidinyl, dihydropyrrolyl, dioxolanyl, oxathiolanyl, dithiolanyl, piperidinyl, tetrahydropyranyl, dihydropyridinyl, thianyl, piperazinyl, morpholinyl, dithianyl, dioxanyl, azepanyl, oxepanyl thiepanyl, azocanyl, oxecanyl and thiocanyl. In certain embodiments, R^(C) is 3-14 membered heterocyclyl selected from tetrahydropyranyl. In certain embodiments, R^(C) is an unsubstituted 3-14 membered heterocyclyl.

In certain embodiments, R^(C) is C₆₋₁₄ aryl. In certain embodiments, R^(C) is a C₆₋₁₄ aryl selected from phenyl, naphthyl and anthracyl. In certain embodiments, R^(C) a C₆₋₁₄ aryl selected from phenyl. In certain embodiments, R^(C) is an unsubstituted C₆₋₁₄ aryl.

In certain embodiments, R^(C) is 5-14 membered heteroaryl. In certain embodiments, R^(C) is 5-10 membered heteroaryl. In certain embodiments, R^(C) is 5-6 membered heteroaryl. In certain embodiments, R^(C) is a 5-membered heteroaryl, e.g., selected from pyrrolyl, furanyl, thiophenyl, imidazolyl, pyrazolyl, oxazolyl, isoxazolyl, thiazolyl, isothiazolyl, triazolyl, oxadiazolyl, thiadiazolyl and tetrazolyl. In certain embodiments, R^(A) is a 6-membered heteroaryl, e.g., selected from pyridinyl, pyridazinyl, pyrimidinyl, pyrazinyl, triazinyl and tetrazinyl. In certain embodiments, R^(C) is an unsubstituted 5-14 membered heteroaryl.

Exemplary Combinations of Groups R^(A), R^(B) and R^(C)

Various combinations of R^(A), R^(B) and/or R^(C) are contemplated herein, and are described in more detail below and herein.

For example, in certain embodiments, both R^(B) and R^(C) are cyclic, i.e., R^(B) is selected from C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl and 5-14 membered heteroaryl, and R^(C) is selected from C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl. In certain embodiments, R^(C) is a group having 2 or more carbon atoms. In certain embodiments, R^(C) is a group having 3 or more carbon atoms. In certain embodiments, R^(C) is a group having 4 or more carbon atoms. In certain embodiments, R^(C) is an unsubstituted cyclic group.

In certain embodiments, R^(B) is cyclic and R^(C) is acyclic, i.e., R^(B) is selected from C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl and 5-14 membered heteroaryl, and R^(C) is selected from —OH, —OR^(C1), —ON(R^(C2))₂, —N(R^(C2))₂, —C(═O)R^(C1), —CHO, —CO₂R^(C1), —C(═O)N(R^(C2))₂, —C(═NR^(C2))OR^(C1), —C(═NR^(C2))N(R^(C2))₂, —SO₂R^(C1), —S(═O)R^(C1), —Si(R^(C1))₃, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, where R^(C1) and R^(C2) are as defined above and herein. In certain embodiments, R^(C) is an acyclic group having 2 or more carbon atoms. In certain embodiments, R^(C) is an acyclic group having 3 or more carbon atoms. In certain embodiments, R^(C) is an acyclic group having 4 or more carbon atoms. In certain embodiments, R^(C) is an unsubstituted acyclic group.

In certain embodiments, R^(A) and R^(B) are independently selected from C₆₋₁₄ aryl and 5-14 membered heteroaryl. In certain embodiments, R^(A) is C₆₋₁₄ aryl, and R^(B) is C₆₋₁₄ aryl or 5-14 membered heteroaryl. In certain embodiments, R^(A) is 5-14 membered heteroaryl, and R^(B) is C₆₋₁₄ aryl or 5-14 membered heteroaryl. In certain embodiments, R^(A) is C₆₋₁₄ aryl or 5-14 membered heteroaryl, and R^(B) is C₆₋₁₄ aryl. In certain embodiments, R^(A) is C₆₋₁₄ aryl or 5-14 membered heteroaryl, and R^(B) is 5-14 membered heteroaryl.

In certain embodiments, both R^(A) and R^(B) are C₆₋₁₄ aryl. In certain embodiments, both R^(A) and R^(B) are phenyl (C₆ aryl). In certain embodiments, R^(A) is C₆₋₁₄ aryl and R^(B) is C₃₋₁₀ carbocyclyl.

In certain embodiments, R^(A) is C₆₋₁₄ aryl and R^(B) is 5-14 membered heteroaryl.

In certain embodiments, R^(A) is C₆₋₁₄ aryl and R^(B) is 3-14 membered heterocyclyl.

In certain embodiments, R^(A) is C₆₋₁₄ aryl and R^(B) and R^(C) together with the nitrogen (N) atom to which each is attached are joined to form a 5-14 membered ring.

In certain embodiments, both R^(A) and R^(B) are 5-14 membered heteroaryl.

In certain embodiments, R^(A) is 5-14 membered heteroaryl and R^(B) is C₃₋₁₀ carbocyclyl.

In certain embodiments, R^(A) is 5-14 membered heteroaryl and R^(B) is C₆₋₁₄ aryl.

In certain embodiments, R^(A) is 5-14 membered heteroaryl and R^(B) is 3-14 membered heterocyclyl.

In certain embodiments, R^(A) is 5-14 membered heteroaryl, and R^(B) and R^(C) together with the nitrogen (N) atom to which each is attached are joined to form a 5-14 membered ring.

In certain embodiments, the compound is of the formula (II):

or a pharmaceutically acceptable form thereof;

wherein R^(C), W—R¹, W—R², W—R³, W—R⁴, W—R⁵, W—R⁶, W—R⁷, W—R⁸, W—R⁹, and W—R¹⁰ are as defined above and herein.

In certain embodiments, at least one of R⁶, R⁷, R⁸, R⁹ and R¹⁰ of the formula (II) is the group -L-R^(D) as defined above and herein. In certain embodiments, at least one of R⁶, R⁷, R⁸, R⁹ and R¹⁰ of the formula (II) is further selected from the group —R^(E) as defined above and herein.

In certain embodiments, the compound is of the formulae (II-a), (II-b) or (II-c):

or a pharmaceutically acceptable form thereof;

wherein R^(C), W—R¹, W—R², W—R³, W—R⁴, W—R⁵, W—R⁷, W—R⁸, W—R⁹, and W—R¹⁰ are as defined above and herein.

In certain embodiments, at least one of R⁷, R⁸, R⁹ and R¹⁰ of the formulae (II-a), (II-b) or (II-c) is the group -L-R^(D) as defined above and herein. In certain embodiments, at least one of R⁷, R⁸, R⁹ and R¹⁰ of the formulae (II-a), (II-b) or (II-c) is further selected from the group —R^(E) as defined above and herein.

In certain embodiments, the compound is of the formula (III):

or a pharmaceutically acceptable form thereof;

wherein R^(C), R¹, R², R³, R⁴, R⁵, W—R⁶, W—R⁷, W—R⁸, W—R⁹, and W—R¹⁰ are as defined above and herein.

In certain embodiments, at least one of R⁶, R⁷, R⁸, R⁹ and R¹⁰ of the compound of formula (III) is the group -L-R^(D) as defined above and herein. In certain embodiments, at least one of R⁶, R⁷, R⁸, R⁹ and R¹⁰ of the compound of formula (III) is further selected from the group —R^(E) as defined above and herein.

In certain embodiments, the compound is of the formulae (III-a), (III-b) or (III-c):

or a pharmaceutically acceptable form thereof;

wherein R^(C), R¹, R², R³, R⁴, R⁵, W—R⁷, W—R⁸, W—R⁹, and W—R¹⁰ are as defined above and herein.

In certain embodiments, at least one of R⁷, R⁸, R⁹ and R¹⁰ of the formulae (III-a), (III-b) or (III-c) is the group -L-R^(D) as defined above and herein. In certain embodiments, at least one of R⁷, R⁸, R⁹ and R¹⁰ of formulae (III-a), (III-b) or (III-c) is further selected from the group —R^(E) as defined above and herein.

In certain embodiments, the compound is of the formula (IV):

or a pharmaceutically acceptable form thereof;

wherein R^(C), R¹, R², R³, R⁴, R⁵, R⁶, R⁷, R⁸, R⁹, and R¹⁰ are as defined above and herein.

In certain embodiments, at least one of R⁶, R⁷, R⁸, R⁹ and R¹⁰ of the formula (IV) is the group -L-R^(D) as defined above and herein. In certain embodiments, at least one of R⁶, R⁷, R⁸, R⁹ and R¹⁰ of the formula (IV) is further selected from the group —R^(E) as defined above and herein. In certain embodiments, R¹-R⁵ are independently H, C₁₋₁₀ alkyl, C₁₋₁₀ alkyloxy, C₆₋₁₄ aryloxy, CN, —SO₂N(R^(A7))₂, —SO₂R^(A6), and —SO₂OR^(A6); R^(C) is unsubstituted C₁₋₁₀ alkyl or unsubstituted C₃₋₁₀ carbocyclyl; and R⁶-R¹⁰ are independently selected from H, C₁₋₁₀ alkyl, C₁₋₁₀ alkyloxy, C₆₋₁₄ aryloxy, COOH, and —CO₂R^(A6). In certain embodiments, R¹-R⁵ are independently H, methyl, methoxy, CN, and SO₂Me; R^(C) is unsubstituted C₁₋₃ alkyl or unsubstituted C₅₋₆ cycloalkyl; and R⁶-R¹⁰ are independently selected from H, methyl, methoxy, phenoxy, COOH, and CO₂Me.

In certain embodiments, the compound is of the formulae (IV-a), (IV-b), (IV-c) or (IV-d):

or a pharmaceutically acceptable form thereof;

wherein R^(C), R¹, R², R³, R⁴, R⁵, R⁶, R⁷, R⁸, R⁹, and R¹⁰ are as defined above and herein.

In certain embodiments, at least one of R⁷, R⁸, R⁹ and R¹⁰ of the formulae (IV-a), (IV-b) or (IV-c) is the group -L-R^(D) as defined above and herein. In certain embodiments, at least one of R⁷, R⁸, R⁹ and R¹⁰ of the formulae (IV-a), (IV-b), (IV-c) or (IV-d) is further selected from the group —R^(E) as defined above and herein.

In one embodiment, provided herein is a compound of formula (IV-d), or a pharmaceutically acceptable form thereof. In one embodiment where the compound is of formula (IV-d), R^(C) is C₁₋₁₀alkyl or C₃₋₁₀carbocyclyl. In one embodiment, R^(C) is ethyl, isopropyl, cyclopentyl or cyclohexyl.

In another embodiment where the compound is of formula (IV-d), R¹ and R² are each independently hydrogen, halogen, —CN, —OR^(A1) or —SO₂R^(A1), wherein R^(A1) is C₁₋₁₀ alkyl. In another embodiment, R¹ and R² are each independently hydrogen, fluoro, methoxy, —CN or —SO₂CH₃.

In another embodiment where the compound is of formula (IV-d), R⁶ and R⁷ are each independently hydrogen, halogen or —O—R^(B1), wherein R^(B1) is C₁₋₁₀ alkyl or C₆₋₁₄aryl. In another embodiment, R⁶ and R⁷ are each independently hydrogen, fluoro, methoxy or phenyloxy.

In certain embodiments, the compound is of the formula (V):

or a pharmaceutically acceptable form thereof;

wherein R^(C), X, Y, Z, R¹, R², R³, R⁶, R⁷, R⁸, R⁹, and R¹⁰ are as defined above and herein.

In certain embodiments, at least one of R⁶, R⁷, R⁸, R⁹ and R¹⁰ of the formula (V) is the group -L-R^(D) as defined above and herein. In certain embodiments, at least one of R⁶, R⁷, R⁸, R⁹ and R¹⁰ of the formula (V) is further selected from the group —R^(E) as defined above and herein.

In certain embodiments, the compound is of the formulae (V-a), (V-b) or (V-c):

or a pharmaceutically acceptable form thereof;

wherein R^(C), X, Y, Z, R¹, R², R³, R⁷, R⁸, R⁹, and R¹⁰ are as defined above and herein.

In certain embodiments, at least one of R⁷, R⁸, R⁹ and R¹⁰ of the formulae (V-a), (V-b) or (V-c) is the group -L-R^(D) as defined above and herein. In certain embodiments, at least one of R⁷, R⁸, R⁹ and R¹⁰ of the formulae (V-a), (V-b) or (V-c) is further selected from the group —R^(E) as defined above and herein.

In certain embodiments, the compound is of the formula (VI):

or a pharmaceutically acceptable form thereof;

wherein R^(C), Y, R¹, R², R³, R⁶, R⁷, R⁸, R⁹, and R¹⁰ are as defined above and herein.

In certain embodiments, at least one of R⁶, R⁷, R⁸, R⁹ and R¹⁰ of the formula (VI) is the group -L-R^(D) as defined above and herein. In certain embodiments, at least one of R⁶, R⁷, R⁸, R⁹ and R¹⁰ of the formula (VI) is further selected from the group —R^(E) as defined above and herein. In certain embodiments, R¹-R³ are independently H, C₁₋₁₀ alkyl, C₁₋₁₀ alkyloxy, C₆₋₁₄ aryloxy, CN, —SO₂N(R^(A7))₂, —SO₂R^(A6), and —SO₂OR^(A6); R^(C) is unsubstituted C₁₋₁₀ alkyl or unsubstituted C₃₋₁₀ carbocyclyl; and R⁶-R¹⁰ are independently selected from H, C₁₋₁₀ alkyl, C₁₋₁₀ alkyloxy, C₆₋₁₄ aryloxy, COOH, and —CO₂R^(A6). In certain embodiments, R¹-R³ are independently H, methyl, methoxy, and CN; R^(C) is unsubstituted C₅₋₆ cycloalkyl; and R⁶-R¹⁰ are independently selected from H, methyl, methoxy, phenoxy, COOH, and CO₂Me.

In certain embodiments, the compound is of the formulae (VI-a), (VI-b) or (VI-c):

or a pharmaceutically acceptable form thereof;

wherein R^(C), Y, R¹, R², R³, R⁷, R⁸, R⁹, and R¹⁰ are as defined above and herein.

In certain embodiments, at least one of R⁷, R⁸, R⁹ and R¹⁰ of the formulae (VI-a), (VI-b) or (VI-c) is the group -L-R^(D) as defined above and herein. In certain embodiments, at least one of R⁷, R⁸, R⁹ and R¹⁰ of the formulae (VI-a), (VI-b) or (VI-c) is further selected from the group —R^(E) as defined above and herein.

Exemplary Compounds

Exemplary compounds are set forth in the Exemplification and listed in Tables 1, 2, 3 and 4 provided therein.

In certain embodiments, a compound of formula (I) is selected from any of the compounds provided in Tables 1, 2, 3 or 4. In certain embodiments, a compound of formula (I) is selected from any of the compounds provided in Table 1. In certain embodiments, a compound of formula (I) is selected from any of the compounds provided in Table 2. In certain embodiments, a compound of formula (I) is selected from any of the compounds provided in Table 3. In certain embodiments, a compound of formula (I) is selected from any of the compounds provided in Table 4.

In certain embodiments, a compound of formula (I) is selected from any of the compounds provided in Tables 1, 2 or 3. In certain embodiments, a compound of formula (I) is selected from any of the compounds provided in Tables 1 or 2. In certain embodiments, a compound of formula (I) is selected from any of the compounds provided in Tables 1 or 3. In certain embodiments, a compound of formula (I) is selected from any of the compounds provided in Tables 1 or 4. In certain embodiments, a compound of formula (I) is selected from any of the compounds provided in Tables 2 or 3. In certain embodiments, a compound of formula (I) is selected from any of the compounds provided in Tables 2 or 4.

Activities provided from the FASN NADPH Consumption Assay are designated in Tables 1, 2, 3 and 4 with a star (*), wherein “A*” refers to compounds having an IC₅₀ of less than 60 nM; “B*” refers to compounds having an IC₅₀ of 60 nM to 250 nM, inclusive; “C*” refers to compounds having an IC₅₀ of greater than 250 nM to 1000 nM, inclusive; “D*” refers to compounds having an IC₅₀ of greater than 1000 nM to 10,000 nM, inclusive; and “E*” refers to compounds having an IC₅₀ of greater than 10,000 nM, as measured by the assay.

Activities provided from the FASN Scintillation Proximity Flashplate Assay are provided in Tables 1, 2, 3 and 4, wherein “A” refers to compounds having an IC₅₀ of less than 15 nM/mL; “B” refers to compounds having an IC₅₀ of 15 nM to 100 nM, inclusive; “C” refers to compounds having an IC₅₀ of greater than 100 nM to 200 nM, inclusive; “D” refers to compounds having an IC₅₀ of greater than 200 nM to 5000 nM, inclusive; and “E” refers to compounds having an IC₅₀ of greater than 5000 nM, as measured by the assay.

In certain embodiments, a compound of formula (I) is any of the compounds provided in Tables 1, 2 or 3 having an activity of “A”, “A*”, “B”, “B*”, “C” or “C*”. In certain embodiments, a compound of formula (I) is any of the compounds provided in Tables 1, 2 or 3 having an activity of “A” or “A*”. In certain embodiments, a compound of formula (I) is any of the compounds provided in Tables 1, 2 or 3 having an activity of “B” or “B*”. In certain embodiments, a compound of formula (I) is any of the compounds provided in Tables 1, 2 or 3 having an activity of “C” or “C*”.

In certain embodiments, compounds provided herein include any of the compounds provided in Tables 1, 2 or 3 substituted with a group -L-R^(D), as defined above and herein, and having an activity of “A”, “A*”, “B” or “B*”.

For example, in certain embodiments, the compound of formula (I) is a compound selected from the group consisting of:

or a pharmaceutically acceptable form thereof.

In certain embodiments, the compound of formula (I) is a compound selected from the group consisting of:

or a pharmaceutically acceptable form thereof.

In other embodiments, the compound of formula (I) is a compound selected from the group consisting of:

or a pharmaceutically acceptable form thereof.

3. Pharmaceutical Compositions and Formulations

In certain embodiments, provided herein is a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof, and one or more pharmaceutically acceptable excipients.

In some embodiments, provided herein is a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof, as provided in Tables 1, 2, 3, or 4 and one or more pharmaceutically acceptable excipients. In other embodiments, provided herein is a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof, as provided in Tables 1, 2, or 3 having an activity of “A”, “A*”, “B” or “B*” and one or more pharmaceutically acceptable excipients. In other embodiments, provided herein is a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof, as provided in Tables 1, 2 or 3 having an activity of “A” or “A*” and one or more pharmaceutically acceptable excipients.

As described above, the pharmaceutical compositions provided herein can comprise a “pharmaceutically acceptable excipient”, which, as used herein, includes any and all solvents, diluents, or other liquid vehicle, dispersion or suspension aids, surface active agents, isotonic agents, thickening or emulsifying agents, preservatives, solid binders, lubricants and the like, as suited to the particular dosage form desired. Remington's Pharmaceutical Sciences, 16th Ed., E. W. Martin (Mack Publishing Co., Easton, Pa., 1980) discloses various pharmaceutically acceptable excipients used in formulating pharmaceutically acceptable compositions and known techniques for the preparation thereof. Except insofar as any conventional excipient medium is incompatible with the compounds provided herein, such as by producing any undesirable biological effect or otherwise interacting in a deleterious manner with any other component(s) of the pharmaceutically acceptable composition, the excipient's use is contemplated to be within the scope of this disclosure. Some examples of materials which can serve as pharmaceutically acceptable excipients include, but are not limited to, ion exchangers, alumina, aluminum stearate, lecithin, serum proteins, such as human serum albumin, buffer substances such as phosphates, glycine, sorbic acid, or potassium sorbate, partial glyceride mixtures of saturated vegetable fatty acids, water, salts or electrolytes, such as protamine sulfate, disodium hydrogen phosphate, potassium hydrogen phosphate, sodium chloride, zinc salts, colloidal silica, magnesium trisilicate, polyvinyl pyrrolidone, polyacrylates, waxes, polyethylene-polyoxypropylene-block polymers, wool fat, sugars such as lactose, glucose and sucrose; starches such as corn starch and potato starch; cellulose and its derivatives such as sodium carboxymethyl cellulose, ethyl cellulose and cellulose acetate; powdered tragacanth; malt; gelatin; talc; excipients such as cocoa butter and suppository waxes; oils such as peanut oil, cottonseed oil; safflower oil; sesame oil; olive oil; corn oil and soybean oil; glycols; such a propylene glycol or polyethylene glycol; esters such as ethyl oleate and ethyl laurate; agar; buffering agents such as magnesium hydroxide and aluminum hydroxide; alginic acid; pyrogen-free water; isotonic saline; Ringer's solution; ethyl alcohol, and phosphate buffer solutions, as well as other non-toxic compatible lubricants such as sodium lauryl sulfate and magnesium stearate, as well as coloring agents, releasing agents, coating agents, sweetening, flavoring and perfuming agents, preservatives and antioxidants can also be present in the pharmaceutically acceptable composition, according to the judgment of the formulator.

In some embodiments, a compound of formula (I) is administered at about 0.01 mg/kg to about 200 mg/kg, such as at about 0.1 mg/kg to about 100 mg/kg, further such as at about 0.5 mg/kg to about 50 mg/kg.

A “subject” to which administration is contemplated includes, but is not limited to, humans (i.e., a male or female of any age group, e.g., a pediatric subject (e.g., infant, child, adolescent) or adult subject (e.g., young adult, middle-aged adult or senior adult)) and/or other primates (e.g., cynomolgus monkeys, rhesus monkeys); mammals, including commercially relevant mammals such as cattle, pigs, horses, sheep, goats, cats, and/or dogs; and/or birds, including commercially relevant birds such as chickens, ducks, geese, and/or turkeys.

The formulations of the pharmaceutically acceptable compositions described herein can be prepared by any method known or hereafter developed in the art of pharmacology. In general, such preparatory methods include the step of bringing the compound of formula (I) into association with one or more pharmaceutically acceptable excipients and then, if necessary and/or desirable, shaping and/or packaging the product into a desired single- or multi-dose unit.

A pharmaceutical composition provided herein can be prepared, packaged, and/or sold in bulk, as a single unit dose, and/or as a plurality of single unit doses. As used herein, a “unit dose” is a discrete amount of the pharmaceutical composition comprising a predetermined amount of at least one compound of formula (I). The amount of the compound of formula (I) is generally equal to the dosage of the compound of formula (I) which would be administered to a subject and/or a convenient fraction of such a dosage such as, for example, one-half or one-third of such a dosage.

The relative amounts of the compound of formula (I), the pharmaceutically acceptable excipient, and/or any additional ingredients in a pharmaceutical composition provided herein will vary, depending upon the identity, size, and/or condition of the subject treated and further depending upon the route by which the composition is to be administered. By way of example, the composition can comprise between 0.1% and 100% (w/w) of the compound of formula (I).

In some embodiments, the pharmaceutically acceptable excipient is at least 95%, 96%, 97%, 98%, 99%, or 100% pure. In some embodiments, the excipient is approved for use in humans and for veterinary use. In some embodiments, the excipient has been approved by United States Food and Drug Administration. In some embodiments, the excipient is pharmaceutical grade. In some embodiments, the excipient meets the standards of the United States Pharmacopoeia (USP), the European Pharmacopoeia (EP), the British Pharmacopoeia, and/or the International Pharmacopoeia.

Pharmaceutically acceptable excipients used in the manufacture of pharmaceutically acceptable compositions include, but are not limited to, inert diluents, dispersing and/or granulating agents, surface active agents and/or emulsifiers, disintegrating agents, binding agents, preservatives, buffering agents, lubricating agents, and/or oils. One or more such excipients can optionally be included in the formulations. Excipients such as cocoa butter and suppository waxes, coloring agents, coating agents, sweetening, flavoring, and perfuming agents can be present in the pharmaceutically acceptable composition, according to the judgment of the formulator.

Exemplary pharmaceutically acceptable excipients include, but are not limited to, diluents such as calcium carbonate, sodium carbonate, calcium phosphate, dicalcium phosphate, calcium sulfate, calcium hydrogen phosphate, sodium phosphate lactose, sucrose, cellulose, microcrystalline cellulose, kaolin, mannitol, sorbitol, inositol, sodium chloride, dry starch, cornstarch, powdered sugar, etc., and combinations thereof.

Exemplary granulating and/or dispersing agents include, but are not limited to, potato starch, corn starch, tapioca starch, sodium starch glycolate, clays, alginic acid, guar gum, citrus pulp, agar, bentonite, cellulose and wood products, natural sponge, cation-exchange resins, calcium carbonate, silicates, sodium carbonate, cross-linked poly(vinyl-pyrrolidone) (crospovidone), sodium carboxymethyl starch (sodium starch glycolate), carboxymethyl cellulose, cross-linked sodium carboxymethyl cellulose (croscarmellose), methylcellulose, pregelatinized starch (starch 1500), microcrystalline starch, water insoluble starch, calcium carboxymethyl cellulose, magnesium aluminum silicate (Veegum), sodium lauryl sulfate, quaternary ammonium compounds, etc., and combinations thereof.

Exemplary surface active agents and/or emulsifiers include, but are not limited to, natural emulsifiers (e.g. acacia, agar, alginic acid, sodium alginate, tragacanth, chondrux, cholesterol, xanthan, pectin, gelatin, egg yolk, casein, wool fat, cholesterol, wax, and lecithin), colloidal clays (e.g. bentonite [aluminum silicate] and Veegum [magnesium aluminum silicate]), long chain amino acid derivatives, high molecular weight alcohols (e.g. stearyl alcohol, cetyl alcohol, oleyl alcohol, triacetin monostearate, ethylene glycol distearate, glyceryl monostearate, and propylene glycol monostearate, polyvinyl alcohol), carbomers (e.g. carboxy polymethylene, polyacrylic acid, acrylic acid polymer, and carboxyvinyl polymer), carrageenan, cellulosic derivatives (e.g. carboxymethylcellulose sodium, powdered cellulose, hydroxymethyl cellulose, hydroxypropyl cellulose, hydroxypropyl methylcellulose, methylcellulose), sorbitan fatty acid esters (e.g. polyoxyethylene sorbitan monolaurate [Tween 20], polyoxyethylene sorbitan [Tween 60], polyoxyethylene sorbitan monooleate [Tween 80], sorbitan monopalmitate [Span 40], sorbitan monostearate [Span 60], sorbitan tristearate [Span 65], glyceryl monooleate, sorbitan monooleate [Span 80]), polyoxyethylene esters (e.g. polyoxyethylene monostearate [Myrj 45], polyoxyethylene hydrogenated castor oil, polyethoxylated castor oil, polyoxymethylene stearate, and Solutol), sucrose fatty acid esters, polyethylene glycol fatty acid esters (e.g. Cremophor), polyoxyethylene ethers, (e.g. polyoxyethylene lauryl ether [Brij 30]), poly(vinyl-pyrrolidone), diethylene glycol monolaurate, triethanolamine oleate, sodium oleate, potassium oleate, ethyl oleate, oleic acid, ethyl laurate, sodium lauryl sulfate, Pluronic F 68, Poloxamer 188, cetrimonium bromide, cetylpyridinium chloride, benzalkonium chloride, docusate sodium, etc. and/or combinations thereof.

Exemplary binding agents include, but are not limited to, starch (e.g. cornstarch and starch paste); gelatin; sugars (e.g. sucrose, glucose, dextrose, dextrin, molasses, lactose, lactitol, mannitol, etc.); natural and synthetic gums (e.g. acacia, sodium alginate, extract of Irish moss, panwar gum, ghatti gum, mucilage of isapol husks, carboxymethylcellulose, methylcellulose, ethylcellulose, hydroxyethylcellulose, hydroxypropyl cellulose, hydroxypropyl methylcellulose, microcrystalline cellulose, cellulose acetate, poly(vinyl-pyrrolidone), magnesium aluminum silicate (Veegum), and larch arabogalactan); alginates; polyethylene oxide; polyethylene glycol; inorganic calcium salts; silicic acid; polymethacrylates; waxes; water; alcohol; etc.; and combinations thereof.

Exemplary preservatives can include antioxidants, chelating agents, antimicrobial preservatives, antifungal preservatives, alcohol preservatives, acidic preservatives, and other preservatives. Exemplary antioxidants include, but are not limited to, alpha tocopherol, ascorbic acid, acorbyl palmitate, butylated hydroxyanisole, butylated hydroxytoluene, monothioglycerol, potassium metabisulfite, propionic acid, propyl gallate, sodium ascorbate, sodium bisulfite, sodium metabisulfite, and sodium sulfite. Exemplary chelating agents include ethylenediaminetetraacetic acid (EDTA), citric acid monohydrate, disodium edetate, dipotassium edetate, edetic acid, fumaric acid, malic acid, phosphoric acid, sodium edetate, tartaric acid, and trisodium edetate. Exemplary antimicrobial preservatives include, but are not limited to, benzalkonium chloride, benzethonium chloride, benzyl alcohol, bronopol, cetrimide, cetylpyridinium chloride, chlorhexidine, chlorobutanol, chlorocresol, chloroxylenol, cresol, ethyl alcohol, glycerin, hexetidine, imidurea, phenol, phenoxyethanol, phenylethyl alcohol, phenylmercuric nitrate, propylene glycol, and thimerosal. Exemplary antifungal preservatives include, but are not limited to, butyl paraben, methyl paraben, ethyl paraben, propyl paraben, benzoic acid, hydroxybenzoic acid, potassium benzoate, potassium sorbate, sodium benzoate, sodium propionate, and sorbic acid. Exemplary alcohol preservatives include, but are not limited to, ethanol, polyethylene glycol, phenol, phenolic compounds, bisphenol, chlorobutanol, hydroxybenzoate, and phenylethyl alcohol. Exemplary acidic preservatives include, but are not limited to, vitamin A, vitamin C, vitamin E, beta-carotene, citric acid, acetic acid, dehydroacetic acid, ascorbic acid, sorbic acid, and phytic acid. Other preservatives include, but are not limited to, tocopherol, tocopherol acetate, deteroxime mesylate, cetrimide, butylated hydroxyanisol (BHA), butylated hydroxytoluened (BHT), ethylenediamine, sodium lauryl sulfate (SLS), sodium lauryl ether sulfate (SLES), sodium bisulfite, sodium metabisulfite, potassium sulfite, potassium metabisulfite, Glydant Plus, Phenonip, methylparaben, Germall 115, Germaben II, Neolone, Kathon, and Euxyl. In certain embodiments, the preservative is an anti-oxidant. In other embodiments, the preservative is a chelating agent.

Exemplary buffering agents include, but are not limited to, citrate buffer solutions, acetate buffer solutions, phosphate buffer solutions, ammonium chloride, calcium carbonate, calcium chloride, calcium citrate, calcium glubionate, calcium gluceptate, calcium gluconate, D-gluconic acid, calcium glycerophosphate, calcium lactate, propanoic acid, calcium levulinate, pentanoic acid, dibasic calcium phosphate, phosphoric acid, tribasic calcium phosphate, calcium hydroxide phosphate, potassium acetate, potassium chloride, potassium gluconate, potassium mixtures, dibasic potassium phosphate, monobasic potassium phosphate, potassium phosphate mixtures, sodium acetate, sodium bicarbonate, sodium chloride, sodium citrate, sodium lactate, dibasic sodium phosphate, monobasic sodium phosphate, sodium phosphate mixtures, tromethamine, magnesium hydroxide, aluminum hydroxide, alginic acid, pyrogen-free water, isotonic saline, Ringer's solution, ethyl alcohol, etc., and combinations thereof.

Exemplary lubricating agents include, but are not limited to, magnesium stearate, calcium stearate, stearic acid, silica, talc, malt, glyceryl behanate, hydrogenated vegetable oils, polyethylene glycol, sodium benzoate, sodium acetate, sodium chloride, leucine, magnesium lauryl sulfate, sodium lauryl sulfate, etc., and combinations thereof.

Exemplary oils include, but are not limited to, almond, apricot kernel, avocado, babassu, bergamot, black current seed, borage, cade, camomile, canola, caraway, carnauba, castor, cinnamon, cocoa butter, coconut, cod liver, coffee, corn, cotton seed, emu, eucalyptus, evening primrose, fish, flaxseed, geraniol, gourd, grape seed, hazel nut, hyssop, isopropyl myristate, jojoba, kukui nut, lavandin, lavender, lemon, litsea cubeba, macademia nut, mallow, mango seed, meadowfoam seed, mink, nutmeg, olive, orange, orange roughy, palm, palm kernel, peach kernel, peanut, poppy seed, pumpkin seed, rapeseed, rice bran, rosemary, safflower, sandalwood, sasquana, savoury, sea buckthorn, sesame, shea butter, silicone, soybean, sunflower, tea tree, thistle, tsubaki, vetiver, walnut, and wheat germ oils. Exemplary oils include, but are not limited to, butyl stearate, caprylic triglyceride, capric triglyceride, cyclomethicone, diethyl sebacate, dimethicone 360, isopropyl myristate, mineral oil, octyldodecanol, oleyl alcohol, silicone oil, and combinations thereof.

Liquid dosage forms for oral and parenteral administration include, but are not limited to, pharmaceutically acceptable emulsions, microemulsions, solutions, suspensions, syrups and elixirs. In addition to the compound of formula (I), the liquid dosage forms can comprise inert diluents commonly used in the art such as, for example, water or other solvents, solubilizing agents and emulsifiers such as ethyl alcohol, isopropyl alcohol, ethyl carbonate, ethyl acetate, benzyl alcohol, benzyl benzoate, propylene glycol, 1,3-butylene glycol, dimethylformamide, oils (in particular, cottonseed, groundnut, corn, germ, olive, castor, and sesame oils), glycerol, tetrahydrofurfuryl alcohol, polyethylene glycols and fatty acid esters of sorbitan, and mixtures thereof. Besides inert diluents, the oral compositions can include adjuvants such as wetting agents, emulsifying and suspending agents, sweetening, flavoring, and perfuming agents. In certain embodiments for parenteral administration, the conjugates provided herein are mixed with solubilizing agents such as Cremophor, alcohols, oils, modified oils, glycols, polysorbates, cyclodextrins, polymers, and combinations thereof. For example, in certain embodiments, the oral suspension can comprise at least one compound of formula (I) and carboxymethylcellulose. In some embodiments, the oral suspension can comprise at least one compound of formula (I), carboxymethylcellulose, and DMSO. In one embodiment, the oral suspension can comprise a compound of formula (I) and 0.5% carboxymethylcellulose/5% DMSO/0.5% Tween (PKPD#5). In another embodiment, the oral suspension can comprise a compound of formula (I) and between about 0.1 and 2% carboxymethylcellulose.

Injectable preparations, for example, sterile injectable aqueous or oleaginous suspensions can be formulated according to the known art using suitable dispersing or wetting agents and suspending agents. The sterile injectable preparation can be a sterile injectable solution, suspension or emulsion in a nontoxic parenterally acceptable diluent or solvent, for example, as a solution in 1,3-butanediol. Among the acceptable vehicles and solvents that can be employed are water, Ringer's solution, U.S.P. and isotonic sodium chloride solution. In addition, sterile, fixed oils are conventionally employed as a solvent or suspending medium. For this purpose any bland fixed oil can be employed including synthetic mono- or diglycerides. In addition, fatty acids such as oleic acid are used in the preparation of injectables.

The injectable formulations can be sterilized, for example, by filtration through a bacterial-retaining filter, or by incorporating sterilizing agents in the form of sterile solid compositions which can be dissolved or dispersed in sterile water or other sterile injectable medium prior to use. Injectable compositions can contain from about 0.1 to about 5% w/w of the compound of formula (I).

In order to prolong the effect of a drug, it is often desirable to slow the absorption of the drug from subcutaneous or intramuscular injection. This can be accomplished by the use of a liquid suspension of crystalline or amorphous material with poor water solubility. The rate of absorption of the drug then depends upon its rate of dissolution which, in turn, can depend upon crystal size and crystalline form. Alternatively, delayed absorption of a parenterally administered drug form can be accomplished by dissolving or suspending the drug in an oil vehicle.

Compositions for rectal or vaginal administration are typically suppositories which can be prepared by mixing the conjugates provided herein with suitable non-irritating excipients such as cocoa butter, polyethylene glycol or a suppository wax which are solid at ambient temperature but liquid at body temperature and therefore melt in the rectum or vaginal cavity and release the compound of formula (I).

Solid dosage forms for oral administration include capsules, tablets, pills, powders, and granules. In such solid dosage forms, the compound of formula (I) is mixed with at least one inert, pharmaceutically acceptable excipient such as sodium citrate or dicalcium phosphate and/or a) fillers or extenders such as starches, lactose, sucrose, glucose, mannitol, and silicic acid, b) binders such as, for example, carboxymethylcellulose, alginates, gelatin, polyvinylpyrrolidinone, sucrose, and acacia, c) humectants such as glycerol, d) disintegrating agents such as agar, calcium carbonate, potato or tapioca starch, alginic acid, certain silicates, and sodium carbonate, e) solution retarding agents such as paraffin, f) absorption accelerators such as quaternary ammonium compounds, g) wetting agents such as, for example, cetyl alcohol and glycerol monostearate, h) absorbents such as kaolin and bentonite clay, and i) lubricants such as talc, calcium stearate, magnesium stearate, solid polyethylene glycols, sodium lauryl sulfate, and mixtures thereof. In the case of capsules, tablets and pills, the dosage form can comprise buffering agents. The unit dose formulation, for example, a tablet, can contain from about 0.05% to about 95% by weight of the compound of formula (I).

Solid compositions of a similar type can be employed as fillers in soft and hard-filled gelatin capsules using such pharmaceutically acceptable excipients as lactose or milk sugar as well as high molecular weight polyethylene glycols and the like. The solid dosage forms of tablets, dragees, capsules, pills, and granules can be prepared with coatings and shells such as enteric coatings and other coatings well known in the pharmaceutical formulating art. They can optionally comprise opacifying agents and can be of a composition that they release the compound of formula (I) only. In some embodiments, the compound of formula (I) can be released in a certain part of the intestinal tract, optionally, in a delayed manner. Examples of embedding compositions which can be used include polymeric substances and waxes. Solid compositions of a similar type can be employed as fillers in soft and hard-filled gelatin capsules using such excipients as lactose or milk sugar as well as high molecular weight polyethylene glycols and the like.

The compound of formula (I) can be in micro-encapsulated form with one or more pharmaceutically acceptable excipients as noted above. In such solid dosage forms, the compound of formula (I) can be admixed with at least one inert diluent such as sucrose, lactose or starch. Such dosage forms can comprise, as is normal practice, additional substances other than inert diluents, e.g., tableting lubricants and other tableting aids such a magnesium stearate and microcrystalline cellulose. In the case of capsules, tablets and pills, the dosage forms can comprise buffering agents.

Dosage forms for topical and/or transdermal administration of a compound of formula (I) provided herein can include ointments, pastes, creams, lotions, gels, powders, solutions, sprays, inhalants and/or patches. Generally, the compound of formula (I) is admixed under sterile conditions with one or more pharmaceutically acceptable excipients and/or any needed preservatives and/or buffers as may be required. Additionally, the use of transdermal patches, which often have the added advantage of providing controlled delivery of a compound of formula (I) to the body, is contemplated herein. Such dosage forms can be prepared, for example, by dissolving and/or dispensing the compound of formula (I) in the proper medium. Alternatively or additionally, the rate can be controlled by either providing a rate controlling membrane and/or by dispersing the compound of formula (I) in a polymer matrix and/or gel.

Suitable devices for use in delivering intradermal pharmaceutically acceptable compositions described herein include short needle devices such as those described in U.S. Pat. Nos. 4,886,499; 5,190,521; 5,328,483; 5,527,288; 4,270,537; 5,015,235; 5,141,496; and 5,417,662. Intradermal compositions can be administered by devices which limit the effective penetration length of a needle into the skin, such as those described in PCT publication WO 99/34850 and functional equivalents thereof. Jet injection devices which deliver liquid vaccines to the dermis via a liquid jet injector and/or via a needle which pierces the stratum corneum and produces a jet which reaches the dermis are suitable. Jet injection devices are described, for example, in U.S. Pat. Nos. 5,480,381; 5,599,302; 5,334,144; 5,993,412; 5,649,912; 5,569,189; 5,704,911; 5,383,851; 5,893,397; 5,466,220; 5,339,163; 5,312,335; 5,503,627; 5,064,413; 5,520,639; 4,596,556; 4,790,824; 4,941,880; 4,940,460; and PCT publications WO 97/37705 and WO 97/13537. Ballistic powder/particle delivery devices which use compressed gas to accelerate vaccine in powder form through the outer layers of the skin to the dermis are suitable. Alternatively or additionally, conventional syringes can be used in the classical mantoux method of intradermal administration.

Formulations suitable for topical administration include, but are not limited to, liquid and/or semi liquid preparations such as liniments, lotions, oil in water and/or water in oil emulsions such as creams, ointments and/or pastes, and/or solutions and/or suspensions. Topically-administrable formulations can, for example, comprise from about 1% to about 10% (w/w) compound of formula (I), although the concentration of the compound of formula (I) can be as high as the solubility limit of the compound of formula (I) in the solvent. In some embodiments, topically-administrable formulations can, for example, comprise from about 1% to about 9% (w/w) compound of formula (I), such as from about 1% to about 8% (w/w), further such as from about 1% to about 7% (w/w), further such as from about 1% to about 6% (w/w), further such as from about 1% to about 5% (w/w), further such as from about 1% to about 4% (w/w), further such as from about 1% to about 3% (w/w), and further such as from about 1% to about 2% (w/w) compound of formula (I). Formulations for topical administration can further comprise one or more of the additional pharmaceutically acceptable excipients described herein.

A pharmaceutical composition provided herein can be prepared, packaged, and/or sold in a formulation suitable for pulmonary administration via the buccal cavity. Such a formulation can comprise dry particles which comprise the compound of formula (I) and which have a diameter in the range from about 0.5 to about 7 nanometers, such as from about 1 to about 6 nanometers, further such as from about 2 to about 5 nanometers, and further such as from about 3 to about 4 nanometers. Such pharmaceutical compositions are conveniently in the form of dry powders for administration using a device comprising a dry powder reservoir to which a stream of propellant can be directed to disperse the powder and/or using a self propelling solvent/powder dispensing container such as a device comprising the compound of formula (I) dissolved and/or suspended in a low-boiling propellant in a sealed container. Such powders comprise particles wherein at least 98% of the particles by weight have a diameter greater than 0.5 nanometers and at least 95% of the particles by number have a diameter less than 7 nanometers. Alternatively, at least 95% of the particles by weight have a diameter greater than 1 nanometer and at least 90% of the particles by number have a diameter less than 6 nanometers. Dry powder compositions can include a solid fine powder diluent such as sugar and can be provided in a unit dose form.

Low boiling propellants generally include liquid propellants having a boiling point of below 65° F. at atmospheric pressure. Generally, the propellant can constitute 50% to 99.9% (w/w) of the pharmaceutical composition, and the active ingredient can constitute 0.1% to 20% (w/w) of the pharmaceutical composition. The propellant can further comprise additional excipients such as a liquid non-ionic and/or solid anionic surfactant and/or a solid diluent (which may have a particle size of the same order as particles comprising the compound of formula (I)).

Pharmaceutical compositions provided herein formulated for pulmonary delivery can provide the compound of formula (I) in the form of droplets of a solution and/or suspension. Such formulations can be prepared, packaged, and/or sold as aqueous and/or dilute alcoholic solutions and/or suspensions, optionally sterile, comprising the compound of formula (I), and can be administered using any nebulization and/or atomization device. Such formulations can further comprise one or more additional excipients including, but not limited to, a flavoring agent such as saccharin sodium, a volatile oil, a buffering agent, a surface active agent, and/or a preservative such as methylhydroxybenzoate. The droplets provided by this route of administration can have an average diameter in the range from about 0.1 to about 200 nanometers.

The formulations described herein as being useful for pulmonary delivery are useful for intranasal delivery of a pharmaceutical composition provided herein. Another formulation suitable for intranasal administration is a coarse powder comprising the compound of formula (I) and having an average particle from about 0.2 to 500 micrometers. Such a formulation is administered, for example, by rapid inhalation through the nasal passage from a container of the powder held close to the nostrils.

Formulations suitable for nasal administration can, for example, comprise from about as little as 0.1% (w/w) and as much as 100% (w/w) of the compound of formula (I), and can comprise one or more of the additional excipients described herein. A pharmaceutical composition provided herein can be prepared, packaged, and/or sold in a formulation suitable for buccal administration. Such formulations can, for example, be in the form of tablets and/or lozenges made using conventional methods, and can, for example, comprise 0.1 to 20% (w/w) of the compound of formula (I), the balance comprising an orally dissolvable and/or degradable composition and, optionally, one or more of the additional pharmaceutically acceptable excipients described herein. In some embodiments, formulations suitable for buccal administration can comprise a powder and/or an aerosolized and/or atomized solution and/or suspension comprising the compound of formula (I). Such powdered, aerosolized, and/or aerosolized formulations, when dispersed, can have an average particle and/or droplet size in the range from about 0.1 to about 200 nanometers, and can further comprise one or more of the additional pharmaceutically acceptable excipients described herein.

A pharmaceutical composition provided herein can be prepared, packaged, and/or sold in a formulation suitable for ophthalmic administration. Such formulations can, for example, be in the form of eye drops including, for example, a 0.1/1.0% (w/w) solution and/or suspension of the compound of formula (I) in an aqueous or oily liquid carrier. Such drops can further comprise buffering agents, salts, and/or one or more other of the additional pharmaceutically acceptable excipients described herein. Other opthalmically-administrable formulations which are useful include those which comprise the compound of formula (I) in microcrystalline form and/or in a liposomal preparation. Ear drops and/or eye drops are contemplated as being within the scope of this disclosure.

General considerations in the formulation and/or manufacture of pharmaceutical compositions can be found, for example, in Remington: The Science and Practice of Pharmacy 21^(st) Ed., (Lippincott Williams & Wilkins, 2005).

Although the descriptions of pharmaceutical compositions provided herein are principally directed to pharmaceutical compositions which are suitable for administration to humans, it will be understood by the skilled artisan that such compositions are generally suitable for administration to animals of all sorts. Modification of pharmaceutical compositions suitable for administration to humans in order to render the compositions suitable for administration to various animals is well understood, and the ordinarily skilled veterinary pharmacologist can design and/or perform such modification with merely ordinary, if any, experimentation.

Further provided herein are kits comprising one or more compounds of formula (I) (or pharmaceutically acceptable forms thereof), and/or an pharmaceutical composition as described above. Kits are typically provided in a suitable container (e.g., for example, a foil, plastic, or cardboard package). In certain embodiments, a kit can include one or more pharmaceutically acceptable excipients, pharmaceutical additives, therapeutically active agents, and the like, as described herein. In certain embodiments, a kit can include means for proper administration, such as, for example, graduated cups, syringes, needles, cleaning aids, and the like. In certain embodiments, a kit can include instructions for proper administration and/or preparation for proper administration.

The instructions would direct the consumer or medical personnel to administer the dosage form according to administration modes known to those skilled in the art. Such kits could be packaged and sold in single or multiple kit units. An example of such a kit is a so-called blister pack. Blister packs are well known in the packaging industry and are being widely used for the packaging of pharmaceutical unit dosage forms (tablets, capsules, and the like). Blister packs generally consist of a sheet of relatively stiff material covered with a foil of a preferably transparent plastic material. During the packaging process, recesses are formed in the plastic foil. The recesses have the size and shape of the tablets or capsules to be packed. Next, the tablets or capsules are placed in the recesses and the sheet of relatively stiff material is sealed against the plastic foil at the face of the foil which is opposite from the direction in which the recesses were formed. As a result, the tablets or capsules are sealed in the recesses between the plastic foil and the sheet. The strength of the sheet is such that the tablets or capsules can be removed from the blister pack by manually applying pressure on the recesses whereby an opening is formed in the sheet at the place of the recess. The tablet or capsule can then be removed via said opening.

It can be desirable to provide a memory aid on the kit, e.g., in the form of numbers next to the tablets or capsules whereby the numbers correspond with the days of the regimen which the tablets or capsules so specified should be ingested. Another example of such a memory aid is a calendar printed on the card, e.g., as follows “First Week, Monday, Tuesday, . . . etc. . . . Second Week, Monday, Tuesday, . . . ” etc. Other variations of memory aids will be readily apparent. A “daily dose” can be a single tablet or capsule or several pills or capsules to be taken on a given day.

4. Uses and Methods of Treatment

4.1 Definitions

As used herein, and unless otherwise specified, the terms “treat,” “treating” and “treatment” contemplate an action that occurs while a subject is suffering from the specified disease, disorder or condition, which reduces the severity of the disease, disorder or condition, or retards or slows the progression of the disease, disorder or condition.

As used herein, unless otherwise specified, the terms “prevent,” “preventing” and “prevention” contemplate an action that occurs before a subject begins to suffer from the specified disease, disorder or condition, which inhibits or reduces the severity of the disease, disorder or condition.

As used herein, and unless otherwise specified, the terms “manage,” “managing” and “management” encompass preventing the recurrence of the specified disease, disorder or condition in a subject who has already suffered from the disease, disorder or condition, and/or lengthening the time that a subject who has suffered from the disease, disorder or condition remains in remission. The terms encompass modulating the threshold, development and/or duration of the disease, disorder or condition, or changing the way that a subject responds to the disease, disorder or condition.

As used herein “inhibition”, “inhibiting”, “inhibit” and “inhibitor”, and the like, refer to the ability of a compound to reduce, slow, halt or prevent activity of a particular biological process (e.g., FASN activity) in a cell relative to vehicle. In certain embodiments, the inhibition results in reduction of the activity by 5%, 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 60%, 70%, 80%, 90% or more of the activity without such inhibition.

As used herein, and unless otherwise specified, a “therapeutically effective amount” of a compound is an amount sufficient to provide a therapeutic benefit in the treatment or management of a disease, disorder or condition, or to delay or minimize one or more symptoms associated with the disease, disorder or condition. A therapeutically effective amount of a compound means an amount of therapeutic agent, alone or in combination with other therapies, which provides a therapeutic benefit in the treatment or management of the disease, disorder or condition. The term “therapeutically effective amount” can encompass an amount that improves overall therapy, reduces or avoids symptoms or causes of disease or condition, or enhances the therapeutic efficacy of another therapeutic agent.

As used herein, and unless otherwise specified, a “prophylactically effective amount” of a compound is an amount sufficient to prevent a disease, disorder or condition, or one or more symptoms associated with the disease, disorder or condition, or prevent its recurrence. A prophylactically effective amount of a compound means an amount of therapeutic agent, alone or in combination with other agents, which provides a prophylactic benefit in the prevention of the disease, disorder or condition. The term “prophylactically effective amount” can encompass an amount that improves overall prophylaxis or enhances the prophylactic efficacy of another prophylactic agent.

4.2 Embodiments

In one embodiment, provided herein are methods for treating, preventing and/or managing a FASN-mediated disorder, disease or condition comprising administering to a subject in need thereof a therapeutically or prophylactically effective amount of at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof.

In another embodiment, provided herein are methods for inhibiting FASN in a subject comprising administering to a subject in need thereof a therapeutically effective amount of at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof.

In another embodiment, provided herein is a method of inhibiting activation of the FASN pathway in vitro or ex vivo, comprising contacting a FASN protein with at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof, in an amount sufficient to reduce the activation of the FASN pathway.

In another embodiment, provided herein is the use of at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof, for the treatment of a FASN-mediated disorder, disease or condition in a subject.

In another embodiment, provided herein is the use of at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof, in the manufacture of a medicament. In certain embodiments, the medicament is useful for treating a FASN-mediated disorder in a subject.

Compounds of formula (I) provided herein can be inhibitors of FASN. A “FASN-mediated disorder” as used herein, refers to a disease, disorder or condition which is treatable by inhibition of FASN activity. FASN-mediated disorders include, but are not limited to, hyperproliferative disorders; inflammatory disorders; obesity related disorders, such as, but not limited to, Type II diabetes mellitus and fatty liver disease; microbial infections, such as, but not limited to, viral, bacterial, fungal, parasitic, and protozoal infections; and complications thereof.

In certain embodiments, the FASN-mediated disorder is a hyperproliferative disorder. In certain embodiments, the hyperproliferative disorder is cancer. To date, aberrant FASN activity has been observed in a variety of hyperproliferative disorders which include, but are not limited to:

(i) bladder cancer (see Visca et al., Anticancer Res. (2003) 23:335-339);

(ii) brain cancer (e.g., meningioma, see: Haase et al., Neuro-Oncology (2010) Advance Access published Feb. 5, 2010, 1-11; e.g., glioma: see Zhao et al., Br. J. Cancer (2006) 95:869-878; e.g., meduloblastoma: see Slade et al., Anticancer Res. (2003) 23:1235-1243);

(iii) breast cancer (see Alo et al., Cancer (1996) 77:474-482; Pizer et al., Cancer Res. (1996) 56:2745-2747; Pizer et al., Cancer Res. (2000) 60:213-218; Milgraum et al., Clin. Cancer Res. (1997) 3:2115-2120; Lupu and Menendez, Endocrinology (2006) 147:4056-4066; Alo et al., Oncol. Rep. (2000) 7:1383-1388; Wang et al., Cancer Lett. (2001) 167:99-104; Liu et al., Mol. Cancer. Ther. (2008) 7:263-270; and Kuhajda et al., PNAS (2000) 97:3450-3454; e.g., mammary cancer: see Hennigar et al., Biochim. Biophys. Acta (1998) 1392:85-100 and Alli et al., Oncogene (2005) 24:39-46);

(iv) colorectal cancer (see Rashid et al., Am. J. Pathol. (1997) 150:201-208; Huang et al., World J. Gastroenterol. (2000) 6:295-297; Zhan et al., Clin. Cancer Res. (2008) 14:5735-5742);

(v) esophageal cancer (see Nemoto et al., Pathobiology (2001) 69:297-303);

(vi) endometrial cancer (see Pizer et al., Cancer (1998) 83:528-537; Pizer et al., Int. J. Gynecol. Pathol. (1997) 16:45-51; Lupu and Menendez, Endocrinology (2006) 147:4056-406; and Sebastiani et al., Gynecologic Oncology (2004) 92:101-105);

(viii) gastric cancer (see Kusakabe et al., Histopathology (2002) 40:71-79);

(ix) gastrointestinal stromal tumor (see Rossi et al., J. Pathol. (2006) 209:369-375);

(x) kidney cancer (e.g., nephroblastoma/Wilms' tumor: see Camassei et al., Med. Pediatr. Oncol. (2003) 40:302-308);

(xi) liver cancer (see Evert et al., Lab. Invest. (2005) 85:99-108);

(xii) lung cancer (see Piyathilake et al., Human Pathol. (2000) 31:1068-1073 and Visca et al., Anticancer Res. (2004) 24:4169-4173);

(xiii) mesothelioma (see Gabrielson et al., Clin. Cancer Research (2001) 7:153-157);

(xiv) multiple myeloma (see Wang et al., J. Zhejiang Univ. Sci B (2008) 9:441-447);

(xv) neuroblastoma (see Slade et al., Anticancer Res. (2003) 23:1235-1243);

(xvi) oral cancer (see Krontiras et al., Head Neck (1999) 21:325-329; and Agostini et al., Oral Oncol. (2004) 40:728-735; see also e.g., oral squamous cell carcinoma (OSCC): Silva et al., Oral Diseases (2007) 14:376-382);

(xvii) ovarian cancer (see Pizer et al., Cancer Res. (1996) 56:1189-1193; Alo et al., Oncol. Rep. (2000) 7:1383-1388; Wang et al., Oncogene (2005) 24:3574-3582; Gansler et al., Hum. Pathol. (1997) 28:686-692; and Zhou et al., Cancer Res. (2007) 2964-2971);

(xviii) pancreatic cancer (e.g., pancreatic andenocarcinoma, intraductal papillary mucinous neoplasm (IPMN): see Walter et al., Cancer Epidemiol. Biomarkers Prev. (2009) 18:2380-2385);

(xix) Pagets disease of the vulva (see Alo et al., Int. J. Gynecol. Pathol. (2005) 24:404-408);

(xx) prostate cancer (see Pizer et al., Proc Am. Assoc. Cancer Res. (2000) 41:655; Swinnen et al., Int. J. Cancer (2002) 98:19-22; Epstein et al., Urology (1995) 45:81-86; De Schrijver et al., Cancer Res. (2003) 63:3799-3804; Pizer et al., Prostate (2001) 47:102-110; Furuya et al., Anticancer Res. (1997) 17:4589-4593; Shurbaji et al., Hum. Pathol. (1996) 27:917-921; Migita et al., J. Nat. Cancer Inst. (2009) 101:519-532; Rossi et al., Mol. Cancer. Res. (2003) 1:707-715; and Shah et al., Hum. Pathol. (2006) 37:401-409);

(xxi) retinoblastoma (see Camassei et al., Investig. Opthalmol. Vis. Sci. (2003) 44:2399-2403; and Slade et al., Anticancer Res. (2003) 23:1235-1243);

(xxii) soft tissue sarcoma (e.g., malignant fibrous histiocytoma (MFH), liposarcoma, malignant peripheral nerve sheath tumor (MPNST), chondrosarcoma: see Takahiro et al., Clin. Cancer Res. (2003) 9:2204-2212);

(xxiii) skin cancer (e.g., melanoma: see Innocenzi et al., J. Cutan. Pathol. (2003) 30:23-28; Kapur et al., Modern Pathology (2005) 18:1107-1112 and Carvalho et al., Int. J. Cancer (2008) 123:2557-2565); and

(xxiv) thyroid cancer (see Vald et al., Mod. Path. (1999) 12:70A; Sekiguchi et al., Biomed. Pharmacother. (2001) 55:466-474; e.g., papillary thyroid carcinoma (PTC): see Uddin et al., J. Clin. Endocrinol. Metab. (2008) 93:4088-4097).

It is envisioned that aberrant FASN activity plays a role in other hyperproliferative disorders. Exemplary hyperproliferative diseases, disorders, conditions or cancers include, but are not limited to, acoustic neuroma, adenocarcinoma, adrenal gland cancer, angiosarcoma (e.g., lymphangiosarcoma, lymphangioendotheliosarcoma, hemangiosarcoma), benign monoclonal gammopathy, biliary cancer (e.g., cholangiocarcinoma), bladder cancer, breast cancer (e.g., adenocarcinoma of the breast, papillary carcinoma of the breast, mammary cancer, medullary carcinoma of the breast), brain cancer (e.g., meningioma; glioma, e.g., astrocytoma, oligodendroglioma; medulloblastoma), bronchus cancer (e.g., bronchogenic carcinoma), cervical cancer (e.g., cervical adenocarcinoma), choriocarcinoma, chordoma, craniopharyngioma, colorectal cancer (e.g., colorectal adenocarcinoma), epithelial carcinoma, ependymoma, endotheliosarcoma (e.g., Kaposi's sarcoma, multiple idiopathic hemorrhagic sarcoma), endometrial cancer, esophageal cancer (e.g., adenocarcinoma of the esophagus, Barrett's adenocarinoma), Ewing sarcoma, familiar hypereosinophilia, gastric cancer (e.g., stomach adenocarcinoma), gastrointestinal stromal tumor (GIST), head and neck cancer, heavy chain disease (e.g., alpha chain disease, gamma chain disease, mu chain disease), hemangioblastoma, inflammatory myofibroblastic tumors, immunocytic amyloidosis, kidney cancer (e.g., nephroblastoma a.k.a. Wilms' tumor, renal cell carcinoma), liver cancer (e.g., hepatocellular cancer (HCC) such as hepatocellular carcinoma, malignant hepatoma), lung cancer (e.g., small cell lung cancer (SCLC), non-small cell lung cancer (NSCLC), adenocarcinoma of the lung), leukemia (e.g., acute lymphocytic leukemia (ALL), acute myelocytic leukemia (AML), chronic myelocytic leukemia (CML), chronic lymphocytic leukemia (CLL)), lymphoma (e.g., Hodgkin lymphoma, non-Hodgkin lymphoma (NHL), follicular lymphoma, diffuse large B-cell lymphoma (DLBCL), mantle cell lymphoma (MCL)), leiomyosarcoma (LMS), mastocytosis (e.g., systemic mastocytosis), multiple myeloma (MM), myelodysplastic syndrome (MDS), mesothelioma, myeloproliferative disorder (MPD) (e.g., polycythemia Vera (PV), essential thrombocytosis (ET), agnogenic myeloid metaplasia (AMM) a.k.a. myelofibrosis (MF), chronic idiopathic myelofibrosis, chronic myelocytic leukemia (CML), chronic neutrophilic leukemia (CNL), hypereosinophilic syndrome (HES)), neuroblastoma, neurofibroma (e.g., neurofibromatosis (NF) type 1 or type 2, schwannomatosis), neuroendocrine cancer (e.g., gastroenteropancreatic neuroendoctrine tumor (GEP-NET), carcinoid tumor), osteosarcoma, oral cancer (e.g., oral squamous cell carcinoma (OSCC)), ovarian cancer (e.g., cystadenocarcinoma, ovarian embryonal carcinoma, ovarian adenocarcinoma), Paget's disease of the vulva, Paget's disease of the penis, papillary adenocarcinoma, pancreatic cancer (e.g., pancreatic andenocarcinoma, intraductal papillary mucinous neoplasm (IPMN)), pinealoma, primitive neuroectodermal tumor (PNT), prostate cancer (e.g., prostate adenocarcinoma), rhabdomyosarcoma, retinoblastoma, salivary gland cancer, skin cancer (e.g., squamous cell carcinoma (SCC), keratoacanthoma (KA), melanoma, basal cell carcinoma), small bowel cancer (e.g., appendix cancer), soft tissue sarcoma (e.g., malignant fibrous histiocytoma (MFH), liposarcoma, malignant peripheral nerve sheath tumor (MPNST), chondrosarcoma, fibrosarcoma, myxosarcoma), sebaceous gland carcinoma, sweat gland carcinoma, synovioma, testicular cancer (e.g., seminoma, testicular embryonal carcinoma), thyroid cancer (e.g., papillary carcinoma of the thyroid, papillary thyroid carcinoma (PTC), medullary thyroid cancer), and Waldenström's macroglobulinemia.

In certain embodiments, the hyperproliferative disorder is selected from bladder cancer, brain cancer, breast cancer, colorectal cancer, esophageal cancer, endometrial cancer, gastric cancer, gastrointestinal stromal tumor, kidney cancer, liver cancer, lung cancer, mesothelioma, multiple myeloma, neuroblastoma, oral cancer, ovarian cancer, pancreatic cancer, prostate cancer, Paget's disease of the vulva, retinoblastoma, soft tissue sarcoma, skin cancer or thyroid cancer.

In certain embodiments, the cancer is selected from mesothelioma, multiple myeloma, neuroblastoma, Paget's disease, retinoblastoma, leukemia, myelodisplastic syndrome, or soft tissue sarcoma.

In certain embodiments, the brain cancer is meningioma, glioma or meduloblastoma.

In certain embodiments, the oral cancer is oral squamous cell carcinoma.

In certain embodiments, the pancreatic cancer is pancreatic andenocarcinoma or intraductal papillary mucinous neoplasm.

In certain embodiments, the soft tissue carcinoma is malignant fibrous histiocytoma, liposarcoma, malignant peripheral nerve sheath tumor, or chondrosarcoma.

In certain embodiments, the skin cancer is melanoma.

In certain embodiments, the thyroid cancer is papillary thyroid carcinoma.

In certain embodiments, the FASN-mediated disorder is an inflammatory disorder. The term “inflammatory disorder” refers to a disease or condition characterized by one or more symptoms of pain, heat, redness, swelling, and loss of function. Inflammatory disorders are meant to encompass inflammation associated with immune system disorders as well as inflammation associated with non-immune system disorders. Inflammatory disorders are meant to encompass acute inflammation and chronic inflammation. To date, aberrant FASN activity has been observed in inflammatory bowel diseases such as ulcerative colitis (see Consolazio et al., Anatomic Pathology (2006) 126:113-118; Rashid et al., Am. J. Pathol. (1997) 150:201-208). It is envisioned that aberrant FASN activity plays a role in other inflammatory disorders.

Exemplary inflammatory disorders include, but are not limited to, inflammation associated with acne, anemia (e.g., aplastic anemia, haemolytic autoimmune anaemia), asthma, arteritis (e.g., polyarteritis, temporal arteritis, periarteritis nodosa, Takayasu's arteritis), arthritis (e.g., crystalline arthritis, osteoarthritis, psoriatic arthritis, gouty arthritis, reactive arthritis, rheumatoid arthritis and Reiter's arthritis), ankylosing spondylitis, amylosis, amyotrophic lateral sclerosis, autoimmune diseases, allergies or allergic reactions, Alzheimer's disease, atherosclerosis, bronchitis, bursitis, cancer, chronic prostatitis, conjunctivitis, Chagas disease, chronic obstructive pulmonary disease, cermatomyositis, diverticulitis, diabetes (e.g., type I diabetes mellitus, type 2 diabetes mellitus), dermatitis, eosinophilic gastrointestinal disorders (e.g., eosinophilic esophagitis, eosinophilic gastritis, eosinophilic gastroenteritis, eosinophilic colitis), eczema, endometriosis, gastrointestinal bleeding, gastritis, gastroesophageal reflux disease (GORD, or its synonym GERD), Guillain-Barre syndrome, infection, ischaemic heart disease, Kawasaki disease, glomerulonephritis, gingivitis, hypersensitivity, headaches (e.g., migraine headaches, tension headaches), ileus (e.g., postoperative ileus and ileus during sepsis), idiopathic thrombocytopenic purpura, interstitial cystitis, inflammatory bowel disease (IBD) (e.g., Crohn's disease, ulcerative colitis, collagenous colitis, lymphocytic colitis, ischaemic colitis, diversion colitis, Behcet's syndrome, indeterminate colitis), inflammatory bowel syndrome (IBS), lupus, multiple sclerosis, morphea, myeasthenia gravis, myocardial ischemia, nephrotic syndrome, pemphigus vulgaris, pernicious aneaemia, peptic ulcers, psoriasis, polymyositis, primary biliary cirrhosis, Parkinson's disease, pelvic inflammatory disease, reperfusion injury, regional enteritis, rheumatic fever, systemic lupus erythematosus, schleroderma, scierodoma, sarcoidosis, spondyloarthopathies, Sjogren's syndrome, thyroiditis, transplantation rejection, tendonitis, trauma or injury (e.g., frostbite, chemical irritants, toxins, scarring, burns, physical injury), vasculitis, vitiligo and Wegener's granulomatosis.

In some embodiment, the inflammatory disorder is selected from anemia, asthma, arteritis, arthritis, chronic obstructive pulmonary disease, dermatitis, gastroesophageal reflux disease, Crohn's disease, inflammatory bowel syndrome, multiple sclerosis, psoriasis and an autoimmune disease.

Inhibition of FASN activity has also been observed to reduce body weight (e.g., by blocking the body's ability to convert carbohydrates to fat) and to suppress appetite (see Loftus et al., Science (2000) 288:2379-2381). Reduction of storage fat is expected to provide various primary and/or secondary benefits in a subject (e.g., in a subject diagnosed with a complication associated with obesity) such as, for example, an increased insulin responsiveness (e.g., in a subject diagnosed with Type II diabetes mellitus); a reduction in elevated blood pressure; a reduction in elevated cholesterol levels; and/or a reduction (or a reduced risk or progression) of ischemic heart disease, arterial vascular disease, angina, myocardial infarction, stroke, migraines, congestive heart failure, deep vein thrombosis, pulmonary embolism, gall stones, gastroesophagael reflux disease, obstructive sleep apnea, obesity hypoventilation syndrome, asthma, gout, poor mobility, back pain, erectile dysfunction, urinary incontinence, liver injury (e.g., fatty liver disease, liver cirrhosis, alcoholic cirrhosis, endotoxin mediated liver injury) or chronic renal failure. Thus, In some embodiments, disclosed methods are applicable to obese subjects, diabetic subjects, and alcoholic subjects, and are generally useful as part of a program to treat an obesity-related disorder or a complication thereof.

An “obesity-related disorder” as used herein, includes, but is not limited to, obesity, undesired weight gain (e.g., from medication-induced weight gain, from cessation of smoking) and an over-eating disorder (e.g., binge eating, bulimia, compulsive eating, or a lack of appetite control each of which can optionally lead to undesired weight gain or obesity). “Obesity” and “obese” as used herein, refers to class I obesity, class II obesity, class III obesity or pre-obesity (e.g., being “over-weight”) as defined by the World Health Organization.

In some embodiments, obesity-related disorder include, but are not limited to, Type II diabetes mellitus, elevated blood pressure, elevated cholesterol levels, ischemic heart disease, arterial vascular disease, angina, myocardial infarction, stroke, migraines, congestive heart failure, deep vein thrombosis, pulmonary embolism, gall stones, gastroesophagael reflux disease, obstructive sleep apnea, obesity hypoventilation syndrome, asthma, gout, poor mobility, back pain, erectile dysfunction, urinary incontinence, liver injury, fatty liver, and chronic renal failure.

In some embodiments, treatment of an obesity-related disorder or complication thereof involves reduction of body weight in the subject. In some embodiments, treatment of an obesity-related disorder or complication thereof involves appetite control in the subject.

In other embodiments, provided herein are methods for treating, preventing and/or managing a microbial infection (e.g., such as a bacterial infection, viral infection, fungal infection, or parasitic or protozoal infection) comprising administering to a subject a therapeutically or prophylactically effective amount of at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof.

Also provided herein is the use of at least one compound of formula (I), or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof, for the treatment, prevention and/or management of a microbial infection in a subject.

Also provided herein is the use of at least one compound of formula (I), or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof, in the manufacture of a medicament useful for treating, preventing and/or managing a microbial infection.

FASN has been identified as a target for treatment of microbial infections, e.g., such as a viral infection, for example, infection with an enveloped virus such as the herpes virus (e.g., human cytomegalomous virus (HCMV), herpes simplex virus 1 (HSV-1), herpes simplex virus 2 (HSV-2), varicella zoster virus (VZV), Epstein-Barr virus), influenza A virus and Heptatitis C virus (HCV) (see Munger et al., Nature Biotechnology (2008) 26: 1179-1186; Syed et al., Trends in Endocrinology and Metabolism (2009) 21:33-40; Sakamoto et al., Nature Chemical Biology (2005) 1:333-337; Yang et al., Hepatology (2008) 48:1396-1403) or a picornavirus such as Coxsackievirus B3 (CVB3) (see Rassmann et al., Anti-viral Research (2007) 76:150-158). Other exemplary viruses include, but are not limited to, the hepatitis B virus, HIV, poxvirus, hepadavirus, retrovirus, and RNA viruses such as flavivirus, togavirus, coronavirus, Hepatitis D virus, orthomyxovirus, paramyxovirus, rhabdovirus, bunyavirus, and filovirus.

In some embodiments, the virus infects humans. In other embodiments, the virus infects non-human animals. In another embodiment, the virus infects primates (e.g., cynomolgus monkeys, rhesus monkeys); mammals, including commercially relevant mammals such as cattle, pigs, horses, sheep, goats, cats, and/or dogs; and/or birds, including commercially relevant birds such as chickens, ducks, geese, and/or turkeys.

In certain embodiments, the virus is an enveloped virus. Examples include, but are not limited to, viruses that are members of the hepadnavirus family, herpesvirus family, iridovirus family, poxvirus family, flavivirus family, togavirus family, retrovirus family, coronavirus family, filovirus family, rhabdovirus family, bunyavirus family, orthomyxovirus family, paramyxovirus family, and arenavirus family. Other examples include, but are not limited to, Hepadnavirus hepatitis B virus (HBV), woodchuck hepatitis virus, ground squirrel (Hepadnaviridae) hepatitis virus, duck hepatitis B virus, heron hepatitis B virus, Herpesvirus herpes simplex virus (HSV) types 1 and 2, varicella-zoster virus, cytomegalovirus (CMV), human cytomegalovirus (HCMV), mouse cytomegalovirus (MCMV), guinea pig cytomegalovirus (GPCMV), Epstein-Barr virus (EBV), human herpes virus 6 (HHV variants A and B), human herpes virus 7 (HHV-7), human herpes virus 8 (HHV-8), Kaposi's sarcoma-associated herpes virus (KSHV), B virus Poxvirus vaccinia virus, variola virus, smallpox virus, monkeypox virus, cowpox virus, camelpox virus, ectromelia virus, mousepox virus, rabbitpox viruses, raccoonpox viruses, molluscum contagiosum virus, orf virus, milker's nodes virus, bovin papullar stomatitis virus, sheeppox virus, goatpox virus, lumpy skin disease virus, fowlpox virus, canarypox virus, pigeonpox virus, sparrowpox virus, myxoma virus, hare fibroma virus, rabbit fibroma virus, squirrel fibroma viruses, swinepox virus, tanapox virus, Yabapox virus, Flavivirus dengue virus, hepatitis C virus (HCV), GB hepatitis viruses (GBV-A, GBV-B and GBV-C), West Nile virus, yellow fever virus, St. Louis encephalitis virus, Japanese encephalitis virus, Powassan virus, tick-borne encephalitis virus, Kyasanur Forest disease virus, Togavirus, Venezuelan equine encephalitis (VEE) virus, chikungunya virus, Ross River virus, Mayaro virus, Sindbis virus, rubella virus, Retrovirus human immunodeficiency virus (HIV) types 1 and 2, human T cell leukemia virus (HTLV) types 1, 2, and 5, mouse mammary tumor virus (MMTV), Rous sarcoma virus (RSV), lentiviruses, Coronavirus, severe acute respiratory syndrome (SARS) virus, Filovirus Ebola virus, Marburg virus, Metapneumoviruses (MPV) such as human metapneumovirus (HMPV), Rhabdovirus rabies virus, vesicular stomatitis virus, Bunyavirus, Crimean-Congo hemorrhagic fever virus, Rift Valley fever virus, La Crosse virus, Hantaan virus, Orthomyxovirus, influenza virus (types A, B, and C), Paramyxovirus, parainfluenza virus (PIV types 1, 2 and 3), respiratory syncytial virus (types A and B), measles virus, mumps virus, Arenavirus, lymphocytic choriomeningitis virus, Junin virus, Machupo virus, Guanarito virus, Lassa virus, Ampari virus, Flexal virus, Ippy virus, Mobala virus, Mopeia virus, Latino virus, Parana virus, Pichinde virus, Punta toro virus (PTV), Tacaribe virus and Tamiami virus.

In some embodiments, the virus is a non-enveloped virus, i.e., the virus does not have an envelope and is naked. Examples include, but are not limited to, viruses that are members of the parvovirus family, circovirus family, polyoma virus family, papillomavirus family, adenovirus family, iridovirus family, reovirus family, birnavirus family, calicivirus family, and picornavirus family. Specific examples include, but are not limited to, canine parvovirus, parvovirus B19, porcine circovirus type 1 and 2, BFDV (Beak and Feather Disease virus, chicken anaemia virus, Polyomavirus, simian virus 40 (SV40), JC virus, BK virus, Budgerigar fledgling disease virus, human papillomavirus, bovine papillomavirus (BPV) type 1, cotton tail rabbit papillomavirus, human adenovirus (HAdV-A, HAdV-B, HAdV-C, HAdV-D, HAdV-E, and HAdV-F), fowl adenovirus A, bovine adenovirus D, frog adenovirus, Reovirus, human orbivirus, human coltivirus, mammalian orthoreovirus, bluetongue virus, rotavirus A, rotaviruses (groups B to G), Colorado tick fever virus, aquareovirus A, cypovirus 1, Fiji disease virus, rice dwarf virus, rice ragged stunt virus, idnoreovirus 1, mycoreovirus 1, Birnavirus, bursal disease virus, pancreatic necrosis virus, Calicivirus, swine vesicular exanthema virus, rabbit hemorrhagic disease virus, Norwalk virus, Sapporo virus, Picornavirus, human polioviruses (1-3), human coxsackieviruses A1-22, 24 (CA1-22 and CA24, CA23 (echovirus 9)), human coxsackieviruses (B1-6 (CB1-6)), human echoviruses 1-7, 9, 11-27, 29-33, vilyuish virus, simian enteroviruses 1-18 (SEV1-18), porcine enteroviruses 1-11 (PEV1-11), bovine enteroviruses 1-2 (BEV1-2), hepatitis A virus, rhinoviruses, hepatoviruses, cardioviruses, aphthoviruses and echoviruses.

In certain embodiments, the virus is a herpes virus, e.g., HSV-I, HSV-2, and CMV. In another embodiment, the virus is HCMV. In another embodiment, the virus is a liver trophic virus. In another embodiment, the virus is an influenza virus. In some embodiments, the virus is HIV. In certain embodiments, the virus is a hepatitis B virus. In a specific embodiment, the virus is EBV. In some embodiments, the virus is Kaposi's sarcoma-associated herpes virus (KSHV). In certain embodiments the virus is a variola virus. In one embodiment, the virus is a Dengue virus. In other embodiments, the virus is a SARS virus. In one embodiment, the virus is an Ebola virus. In some embodiments the virus is a Marburg virus. In certain embodiments, the virus is a measles virus. In particular embodiments, the virus is a vaccinia virus. In some embodiments, the virus is varicella-zoster virus (VZV). In some embodiments, the virus is a picornavirus. In certain embodiments the virus is a rhinovirus. In certain embodiments the virus is not a rhinovirus. In some embodiments, the virus is an adenovirus. In particular embodiments, the virus is a coxsackievirus (e.g., coxsackievirus B3). In some embodiments, the virus is a rhinovirus. In certain embodiments, the virus is a human papillomavirus (HPV).

In certain embodiments, the virus is a DNA virus. In other embodiments, the virus is an RNA virus. In one embodiment, the virus is a DNA or a RNA virus with a single-stranded genome. In another embodiment, the virus is a DNA or a RNA virus with a double-stranded genome.

In some embodiments, the virus has a linear genome. In other embodiments, the virus has a circular genome. In some embodiments, the virus has a segmented genome. In other embodiments, the virus has a non-segmented genome.

In some embodiments, the virus is a positive-stranded RNA virus.

In other embodiments, the virus is a negative-stranded RNA virus. In one embodiment, the virus is a segmented, negative-stranded RNA virus. In another embodiment, the virus is a non-segmented negative-stranded RNA virus.

In some embodiments, the virus is an icosahedral virus. In other embodiments, the virus is a helical virus. In yet other embodiments, the virus is a complex virus.

In some embodiments, the virus is a hepatitis C virus.

In certain embodiments, the virus is selected from: a herpes virus such as HSV-1, HSV-2, VZV, EBV, CMV (HCMV, MCMV, GPCMV), HMCV, CVB3, HHV-6 and HHV-8; an influenza virus such as influenza type A and influenza type B; respiratory viruses such as RSV, PIV (types 1, 2 and 3), measles virus, rhinovirus, adenovirus, HMPV and SARS virus; orthopoxviruses such as vaccinia virus, cowpox virus, ectromelia virus, monkeypox virus and rabbitpox virus; a hepatitis virus such as HBV and HCV; a papova virus such as papillomavirus (e.g., cotton tail rabbit papillomavirus and human papillomavirus) and BK virus; or other viruses such as VEE virus, Rift Valley fever virus, Tacaribe virus, Yellow fever virus, West Nile virus, dengue virus, PTV and Pichinde virus.

In one embodiment, the virus is HSV-1. In another embodiment, the virus is HSV-2. In another embodiment, the virus is VZV. In another embodiment, the virus is EBV. In another embodiment, the virus is HCMV. In another embodiment, the virus is MCMV. In another embodiment, the virus is GPCMV. In another embodiment, the virus is HHV-6. In another embodiment, the virus is HHV-8.

In one embodiment, the virus is influenza type A virus. In another embodiment, the virus is influenza type B virus.

In one embodiment, the virus is RSV. In another embodiment, the virus is PIV-3. In another embodiment, the virus is measles virus. In another embodiment, the virus is rhinovirus. In another embodiment, the virus is adenovirus. In another embodiment, the virus is HMPV. In another embodiment, the virus is SARS virus.

In one embodiment, the virus is vaccinia virus. In another embodiment, the virus is cowpox virus. In another embodiment, the virus is ectromelia virus. In another embodiment, the virus is monkeypox virus. In another embodiment, the virus is rabbitpox virus.

In one embodiment, the virus is HBV. In another embodiment, the virus is HCV.

In one embodiment, the virus is cotton tail rabbit papillomavirus. In another embodiment, the virus is human papillomavirus. In another embodiment, the virus is BK virus.

In one embodiment, the virus is VEE virus. In another embodiment, the virus is Rift Valley fever virus. In another embodiment, the virus is Tacaribe virus. In another embodiment, the virus is Yellow fever virus. In another embodiment, the virus is West Nile virus. In another embodiment, the virus is dengue virus. In another embodiment, the virus is PTV. In another embodiment, the virus is Pichinde virus.

In certain embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat an infection caused by one type of virus. In other embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat one or more infections caused by two or more types of viruses at the same time. In other embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat one or more infections caused by three or more types of viruses at the same time. In other embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat one or more infections caused by four or more types of viruses at the same time. In other embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat one or more infections caused by five or more types of viruses at the same time. In other embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat one or more infections caused by six, seven, eight, nine, ten, fifteen, twenty or more types of viruses at the same time.

In certain embodiments, the microbial infections can encompass the disease related to infection by prions, e.g., scrapie, madcow disease, and any modified forms thereof. In certain embodiments, the microbial infections encompass those prion diseases that affect humans.

It is envisioned that a compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein will also be useful in the treatment of other microbial infections, such as bacterial infections, fungal infections, and parasitic infections.

In certain embodiments, the microbial infection is a bacterial infection. Examples of bacterial infections include, but are not limited to, infections by mycobacteria (e.g., Mycobacteria tuberculosis, M. bovis, M. avium, M. leprae, and M. africanum), rickettsia, mycoplasma, chlamydia, and legionella. Other examples of bacterial infections include, but are not limited to, infections caused by Gram positive bacillus (e.g., Listeria, Bacillus such as Bacillus anthracis, Erysipelothrix species), Gram negative bacillus (e.g., Bartonella, Brucella, Campylobacter, Enterobacter, Escherichia, Francisella, Hemophilus, Klebsiella, Morganella, Proteus, Providencia, Pseudomonas, Salmonella, Serratia, Shigella, Vibrio and Yersinia species), spirochete bacteria (e.g., Borrelia species including Borrelia burgdorferi that causes Lyme disease), anaerobic bacteria (e.g., Actinomyces and Clostridium species), Gram positive and negative coccal bacteria, Enterococcus species, Streptococcus species, Pneumococcus species, Staphylococcus species, and Neisseria species.

Specific examples of infectious bacteria include, but are not limited to: Helicobacter pyloris, Borelia burgdorferi, Legionella pneumophilia, Mycobacteria tuberculosis, M. avium, M. intracellulare, M. kansaii, M. gordonae, Staphylococcus aureus, Neisseria gonorrhoeae, Neisseria meningitidis, Listeria monocytogenes, Streptococcus pyogenes (Group A Streptococcus), Streptococcus agalactiae (Group B Streptococcus), Streptococcus viridans, Streptococcus faecalis, Streptococcus bovis, Streptococcus pneumoniae, Haemophilus influenzae, Bacillus antracis, corynebacterium diphtheriae, Erysipelothrix rhusiopathiae, Clostridium perfringens, Clostridium tetani, Enterobacter aerogenes, Klebsiella pneumoniae, Pasturella multocida, Fusobacterium nucleatum, Streptobacillus moniliformis, Treponema pallidium, Treponema pertenue, Leptospira, Rickettsia, and Actinomyces israelli.

In one embodiment, the bacterial infection is an infection caused by Mycobacteria tuberculosis.

In certain embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat an infection caused by one type of bacteria. In other embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat one or more infections caused by two or more types of bacteria at the same time. In other embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat one or more infections caused by three or more types of bacteria at the same time. In other embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat one or more infections caused by four or more types of bacteria at the same time. In other embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat one or more infections caused by five or more types of bacteria at the same time. In other embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat one or more infections caused by six, seven, eight, nine, ten, fifteen, twenty or more types of bacteria at the same time.

In certain embodiments, provided herein are methods of treating, preventing and/or managing diseases, disorders, or conditions caused by fungal infection. Examples include, but are not limited to, aspergilliosis, crytococcosis, sporotrichosis, coccidioidomycosis, paracoccidioidomycosis, histoplasmosis, blastomycosis, zygomycosis, and candidiasis.

In certain embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat an infection caused by one type of fungi. In other embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat one or more infections caused by two or more types of fungi at the same time. In other embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat one or more infections caused by three or more types of fungi at the same time. In other embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat one or more infections caused by four or more types of fungi at the same time. In other embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat one or more infections caused by five or more types of fungi at the same time. In other embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat one or more infections caused by six, seven, eight, nine, ten, fifteen, twenty or more types of fungi at the same time.

In certain embodiments, provided herein are methods of treating, preventing and/or managing diseases, disorders, or conditions caused by parasitic or protozoal infection. Examples of parasitic or protozoal diseases and disorders include, but are not limited to, diseases, disorders and conditions caused by parasites such as, but not limited to, P. falcifarium, P. ovale, P. vivax, P. malariae, L. donovari, L. infantum, L. aethiopica, L. major, L. tropica, L. mexicana, L. braziliensis, T. Gondii, B. microti, B. divergens, B. coli, B. hominis, C. parvum, C. cayetanensis, D. fragilis, E. histolytica, I. belli, S. mansonii, S. haematobium, Trypanosoma ssp., Toxoplasma ssp., and O. volvulus. Other diseases, disorders and conditions include, but are not limited to, those caused by Babesia bovis, Babesia canis, Banesia Gibsoni, Besnoitia darlingi, Cytauxzoon felis, Eimeria ssp., Hammondia ssp., T. canis, Cestoda (i.e., tapeworms) and Theileria ssp. Specific diseases, disorders and conditions include, but are not limited to, malaria, babesiosis, trypanosomiasis, American trypanosomiasis (i.e., Chagas disease), leishmaniasis, toxoplasmosis, meningoencephalitis, keratitis, amebiasis, giardiasis, cryptosporidiosis, isosporiasis, cyclosporiasis, microsporidiosis, ascariasis, trichuriasis, ancylostomiasis, strongyloidiasis, toxocariasis, trichinosis, lymphatic filariasis, onchocerciasis, filariasis, schistosomiasis, and dermatitis caused by animal schistosomes.

In one embodiment, the parasitic or protozoal disease is malaria. In another embodiment, the parasitic or protozoal disease is leishmaniasis. In another embodiment, the parasitic or protozoal disease is babesiosis. In another embodiment, the parasitic or protozoal disease is toxoplasmosis. In another embodiment, the parasitic or protozoal disease is trypanosomiasis.

In certain embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat an infection caused by one type of parasite. In other embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat one or more infections caused by two or more types of parasite at the same time. In other embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat one or more infections caused by three or more types of parasite at the same time. In other embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat one or more infections caused by four or more types of parasite at the same time. In other embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat one or more infections caused by five or more types of parasite at the same time. In other embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can treat one or more infections caused by six, seven, eight, nine, ten, fifteen, twenty or more types of parasite at the same time.

In some embodiments, compounds provided herein can treat infection by any combination of viruses, bacteria, fungi and parasites at the same time. For example, in certain embodiments, compounds provided herein can treat the infection by one or more viruses and one or more fungi. In other embodiments, compounds provided herein can treat the infection by one or more viruses and one or more bacteria. In other embodiments, compounds provided herein can treat the infection by one or more fungi and one or more bacteria. In other embodiments, compounds provided herein can treat the infection by one or more viruses and one or more parasites. In other embodiments, compounds provided herein can treat the infection by one or more fungi and one or more parasites. In other embodiments, compounds provided herein can treat the infection by one or more bacteria and one or more parasites. In other embodiments, compounds provided herein can treat the infection by one or more viruses, one or more fungi and one or more bacteria. In other embodiments, compounds provided herein can treat the infection by one or more bacteria, one or more fungi and one or more parasites. In other embodiments, compounds provided herein can treat the infection by one or more viruses, one or more fungi and one or more parasites. In other embodiments, compounds provided herein can treat the infection by one or more viruses, one or more bacteria and one or more parasites.

Compounds provided herein are inhibitors of FASN. Thus, in certain embodiments, the compounds provided herein can be used to treat and/or manage other FASN-related disorders, examples of which include, but are not limited to, diabetes and general wellness of liver such as treatment, prevention and/or management of fatty liver.

In certain embodiments, the compound is an inhibitor of palmitate synthesis. As used herein “inhibition”, “inhibiting”, “inhibit” and “inhibitor”, and the like, refer to the ability of a compound to reduce, halt or prevent activity of a particular biological process (e.g., FASN activity, palmitate synthesis) in a cell relative to vehicle.

In other embodiments, provided herein are methods for inhibiting ELOVL in a subject comprising administering to a subject in need thereof a therapeutically effective amount of at least one compound of formula (I) or a pharmaceutically acceptable form thereof.

In another embodiment, provided herein is use of at least one compound of formula (I) for the treatment of a ELOVL-mediated disorder in a subject.

In another embodiment, provided herein is use of at least one compound of formula (I) in the manufacture of a medicament. In certain embodiments, the medicament is useful for treating a ELOVL-mediated disorder.

“ELOVL-mediated disorder” as used herein, refers to a disease, disorder or condition which is treatable by inhibition of ELOVL activity. Typically, ELOVL-mediated disorders are substantially similar to those mediated by FASN. Thus, ELOVL-mediated disorders include the FASN-mediated disorders described herein above. Examples include, but are not limited to, hyperproliferative disorders, inflammatory disorders, obesity-related disorders and complications thereof, diabetes and general wellness of liver such as treatment, prevention and/or management of fatty liver.

In one embodiment, the ELOVL-mediated disorder is a hyperproliferative disorder. In another embodiment, the ELOVL-mediated disorder is an inflammatory disorder. In another embodiment, the ELOVL-mediated disorder is obesity. In another embodiment, the ELOVL-mediated disorder is diabetes mellitus. In another embodiment, the ELOVL-mediated disorder is fatty liver.

In one embodiment, the ELOVL-mediated disorder is ELOVL6-mediated disorder.

5. Administration

The compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof can be administered using any amount and any route of administration effective for treatment. The compounds provided herein are typically formulated in dosage unit form for ease of administration and uniformity of dosage. It will be understood, however, that the total daily usage of the compounds provided herein will be decided by the attending physician within the scope of sound medical judgment. The specific therapeutically effective dose level for any particular subject will depend upon a variety of factors including the disease, disorder, or condition being treated and its severity; the activity of the specific compound employed; the specific composition employed; the species, age, body weight, general health, sex and diet of the subject; the time of administration, route of administration, and rate of excretion of the specific compound employed; the duration of the treatment; drugs used in combination or coincidental with the specific compound employed; and like factors well known in the medical arts.

A therapeutically effective amount of at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof disclosed herein can be measured by the therapeutic effectiveness of the compound. Compounds of formula (I) can be administered in a dose of about 1 μg/kg to about 200 mg/kg daily; such as from about 1 μg/kg to about 150 mg/kg, from about 1 mg/kg to about 200 mg/kg, from about 1 μg/kg to about 100 mg/kg, from about 1 μg/kg to about 1 mg/kg, from about 50 μg/kg to about 200 mg/kg, from about 10 μg/kg to about 1 mg/kg, from about 10 μg/kg to about 100 μg/kg, from about 100 μg to about 10 mg/kg, and from about 500 μg/kg to about 50 mg/kg.

In certain embodiments, a therapeutically effective amount of at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof for administration one or more times a day to a 70 kg adult human can comprise about 0.0001 mg to about 1000 mg of an compound per unit dosage form. It will be appreciated that dose ranges as described herein provide guidance for the administration of pharmaceutical compositions to an adult. The amount to be administered to, for example, a child or an adolescent can be determined by a medical practitioner or person skilled in the art and can be lower or the same as that administered to an adult.

The desired dosage can be delivered three times a day, two times a day, once a day, every other day, every third day, every week, every two weeks, every three weeks, or every four weeks. In certain embodiments, the desired dosage can be delivered using multiple administrations (e.g., two, three, four, five, six, seven, eight, nine, ten, eleven, twelve, thirteen, fourteen, or more administrations).

In one embodiment, the therapeutically effective amount of a disclosed compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof is sufficient to establish a maximal plasma concentration ranging from about 0.001 μM to about 100 μM, e.g., from about 1 μM to about 20 μM. Preliminary doses as, for example, determined according to animal tests, and the scaling of dosages for human administration is performed according to art-accepted practices.

The therapeutically effective dose can be estimated initially from cell culture assays. A dose can be formulated in animal models to achieve a circulating plasma concentration range that includes the IC₅₀ (i.e., the concentration of the therapeutic which achieves a half-maximal inhibition of symptoms) as determined in cell culture assays or animal models. Levels in plasma can be measured, for example, by high performance liquid chromatography. The effects of any particular dosage can be monitored by a suitable bioassay. Examples of dosages are: about 0.1×IC₅₀, about 0.5×IC₅₀, about 1×IC₅₀, about 5×IC₅₀, 10×IC₅₀, about 50×IC₅₀, and about 100×IC₅₀.

Therapeutically effective dosages achieved in one animal model can be converted for use in another animal, including humans, using conversion factors known in the art (see, e.g., Freireich et al., Cancer Chemother. Reports 50(4):219-244 (1966) and Table A for Equivalent Surface Area Dosage Factors).

TABLE A To: Mouse Rat Monkey Dog Human From: (20 g) (150 g) (3.5 kg) (8 kg) (60 kg) Mouse 1 1/2 1/4 1/6  1/12 Rat 2 1 1/2 1/4 1/7 Monkey 4 2 1 3/5 1/3 Dog 6 4 3/5 1 1/2 Human 12 7 3 2 1

In some embodiments, the compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof is administered via a variety of routes, including oral, intravenous, intramuscular, intra-arterial, intramedullary, intrathecal, subcutaneous, intraventricular, transdermal, interdermal, rectal, intravaginal, intraperitoneal, topical (as by powders, ointments, creams, and/or drops), mucosal, nasal, bucal, enteral, sublingual; by intratracheal instillation, bronchial instillation, and/or inhalation; and/or as an oral spray, nasal spray, and/or aerosol. Specifically contemplated routes are systemic intravenous injection, regional administration via blood and/or lymph supply, and/or direct administration to an affected site. In general the most appropriate route of administration will depend upon a variety of factors including the nature of the agent (e.g., its stability in the environment of the gastrointestinal tract), the condition of the subject (e.g., whether the subject is able to tolerate oral administration), etc. At present the oral and/or nasal spray and/or aerosol route is most commonly used to deliver therapeutic agents directly to the lungs and/or respiratory system. However, the delivery of the pharmaceutical composition by any appropriate route, taking into consideration likely advances in the sciences of drug delivery, is also encompassed herein.

It will be also appreciated that at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof, as described above and herein, can be administered in combination with one or more additional therapeutically active agents.

By “in combination with,” it is not intended to imply that the agents must be administered at the same time and/or formulated for delivery together, although these methods of delivery are certainly within the scope of this disclosure. The compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof can be administered concurrently with, prior to, or subsequent to, one or more other additional therapeutically active agents. In general, each agent will be administered at a dose and/or on a time schedule determined for that agent. In will further be appreciated that the additional therapeutically active agent utilized in this combination can be administered together in a single composition or administered separately in different compositions. The particular combination to employ in a regimen will take into account compatibility of the compound of formula (I) with the additional therapeutically active agent and/or the desired therapeutic effect to be achieved.

In some embodiments, additional therapeutically active agents utilized in combination with at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof will be administered at levels that do not exceed the levels at which they are utilized individually. In some embodiments, the levels utilized in combination will be lower than those utilized individually.

By a “therapeutically active agent”, “therapeutic agent”, “agent” or “active agent” refers to any substance that is useful for therapy, including prophylactic and therapeutic treatment.

Also encompassed herein is the delivery of the pharmaceutical compositions in combination with agents that can improve their bioavailability, reduce and/or modify their metabolism, inhibit their excretion, and/or modify their distribution within the body. It will also be appreciated that the therapy employed can achieve a desired effect for the same disorder (for example, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof can be administered in combination with an anti-inflammatory, anti-anxiety and/or anti-depressive agent, etc.), and/or they can achieve different effects (e.g., control of any adverse side-effects).

Exemplary therapeutically active agents include, but are not limited to, anti-cancer agents, antibiotics, anti-obesity drugs, anti-viral agents, anesthetics, anti-coagulants, inhibitors of an enzyme, steroidal agents, anti-inflammatory agents, antihistamine, immunosuppressant agents, anti-neoplastic agents, antigens, vaccines, antibodies, decongestants, sedatives, opioids, pain-relieving agents, analgesics, anti-pyretics, enhancing agents, hormones, prostaglandins, progestational agents, anti-glaucoma agents, ophthalmic agents, anti-cholinergics, anti-depressants, anti-psychotics, hypnotics, tranquilizers, anti-convulsants, muscle relaxants, anti-spasmodics, muscle contractants, channel blockers, miotic agents, anti-secretory agents, anti-thrombotic agents, anticoagulants, anti-cholinergics, β-adrenergic blocking agents, diuretics, cardiovascular active agents, vasoactive agents, vasodilating agents, anti-hypertensive agents, angiogenic agents, modulators of cell-extracellular matrix interactions (e.g. cell growth inhibitors and anti-adhesion molecules), or inhibitors/intercalators of DNA, RNA, protein-protein interactions, protein-receptor interactions, etc. Active agents include small organic molecules such as drug compounds (e.g., compounds approved by the Food and Drugs Administration as provided in the Code of Federal Regulations (CFR)), antibodies, peptides, proteins, carbohydrates, monosaccharides, oligosaccharides, polysaccharides, nucleoproteins, mucoproteins, lipoproteins, synthetic polypeptides or proteins, small molecules linked to proteins, glycoproteins, steroids, nucleic acids, DNAs, RNAs, nucleotides, nucleosides, oligonucleotides, antisense oligonucleotides, lipids, hormones, antibodies, vitamins and cells, and combinations thereof.

In certain embodiments, the therapeutically active agent is an anti-cancer agent. Exemplary anti-cancer agents, include, but are not limited to, radiation therapy, interferon (e.g., interferon α, interferon γ), antibodies (e.g., HERCEPTIN (trastuzumab), T-DM1, AVASTIN (bevacizumab), ERBITUX (cetuximab), VECTIBIX (panitumumab), RITUXAN (rituximab) BEXXAR (tositumomab)), anti-estrogens (e.g., tamoxifen, raloxifene, and megestrol), LHRH agonists (e.g., goscrclin and leuprolide), anti-androgens (e.g., flutamide and bicalutamide), photodynamic therapies (e.g., vertoporfin (BPD-MA), phthalocyanine, photosensitizer Pc4, and demethoxy-hypocrellin A (2BA-2-DMHA)), nitrogen mustards (e.g., cyclophosphamide, ifosfamide, trofosfamide, chlorambucil, estramustine, and melphalan), nitrosoureas (e.g., carmustine (BCNU) and lomustine (CCNU)), alkylsulphonates (e.g., busulfan and treosulfan), triazenes (e.g., dacarbazine, temozolomide), platinum containing compounds (e.g., cisplatin, carboplatin, oxaliplatin), vinca alkaloids (e.g., vincristine, vinblastine, vindesine, and vinorelbine), taxoids (e.g., paclitaxel, albumin-bound paclitaxel (ABRAXANE), nab-paclitaxel, docetaxel, taxol), epipodophyllins (e.g., etoposide, etoposide phosphate, teniposide, topotecan, 9-aminocamptothecin, camptoirinotecan, irinotecan, crisnatol, mytomycin C), anti-metabolites, DHFR inhibitors (e.g., methotrexate, dichloromethotrexate, trimetrexate, edatrexate), IMP dehydrogenase Inhibitors (e.g., mycophenolic acid, tiazofurin, ribavirin, and EICAR), ribonucleotide reductase inhibitors (e.g., hydroxyurea and deferoxamine), uracil analogs (e.g., 5-fluorouracil (5-FU), floxuridine, doxifluridine, ratitrexed, tegafur-uracil, capecitabine), cytosine analogs (e.g., cytarabine (ara C), cytosine arabinoside, and fludarabine), purine analogs (e.g., mercaptopurine and Thioguanine), Vitamin D3 analogs (e.g., EB 1089, CB 1093, and KH 1060), isoprenylation inhibitors (e.g., lovastatin), dopaminergic neurotoxins (e.g., 1-methyl-4-phenylpyridinium ion), cell cycle inhibitors (e.g., staurosporine), actinomycin (e.g., actinomycin D, dactinomycin), bleomycin (e.g., bleomycin A2, bleomycin B2, peplomycin), anthracycline (e.g., daunorubicin, doxorubicin, pegylated liposomal doxorubicin, idarubicin, epirubicin, pirarubicin, zorubicin, mitoxantrone), MDR inhibitors (e.g., verapamil), Ca2+ ATPase inhibitors (e.g., thapsigargin), imatinib, thalidomide, lenalidomide, tyrosine kinase inhibitors tyrosine kinase inhibitors (e.g., axitinib (AG013736), bosutinib (SKI-606), cediranib (RECENTIN™, AZD2171), dasatinib (SPRYCEL®, BMS-354825), erlotinib (TARCEVA®), gefitinib (IRESSA®), imatinib (Gleevec®, CGP57148B, STI-571), lapatinib (TYKERB®, TYVERB®), lestaurtinib (CEP-701), neratinib (HKI-272), nilotinib (TASIGNA®), semaxanib (semaxinib, SU5416), sunitinib (SUTENT®, SU11248), toceranib (PALLADIA®), vandetanib (ZACTIMA®, ZD6474), vatalanib (PTK787, PTK/ZK), trastuzumab (HERCEPTIN®), bevacizumab (AVASTIN®), rituximab (RITUXAN®), cetuximab (ERBITUX®), panitumumab (VECTIBIX®), ranibizumab (Lucentis®), nilotinib (TASIGNA®), sorafenib (NEXAVAR®), everolimus (AFINITOR®), alemtuzumab (CAMPATH®), gemtuzumab ozogamicin (MYLOTARG®), temsirolimus (TORISEL®), ENMD-2076, PCI-32765, AC220, dovitinib lactate (TKI258, CHIR-258), BIBW 2992 (TOVOK™), SGX523, PF-04217903, PF-02341066, PF-299804, BMS-777607, ABT-869, MP470, BIBF 1120 (VARGATEF®), AP24534, JNJ-26483327, MGCD265, DCC-2036, BMS-690154, CEP-11981, tivozanib (AV-951), OSI-930, MM-121, XL-184, XL-647, and/or XL228), proteasome inhibitors (e.g., bortezomib (VELCADE)), mTOR inhibitors (e.g., rapamycin, temsirolimus (CCI-779), everolimus (RAD-001), ridaforolimus, AP23573 (Ariad), AZD8055 (AstraZeneca), BEZ235 (Novartis), BGT226 (Norvartis), XL765 (Sanofi Aventis), PF-4691502 (Pfizer), GDC0980 (Genetech), SF1126 (Semafoe) and OSI-027 (OSI)), oblimersen, gemcitabine, caminomycin, leucovorin, pemetrexed, cyclophosphamide, dacarbazine, procarbizine, prednisolone, dexamethasone, campathecin, plicamycin, asparaginase, aminopterin, methopterin, porfiromycin, melphalan, leurosidine, leurosine, chlorambucil, trabectedin, procarbazine, discodermolide, caminomycin, aminopterin, and hexamethyl melamine.

Exemplary combinations of therapeutically active agents useful for the treatment of cancer (a.k.a. an “anti-cancer treatment regimen”) which can be used in combination with at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof includes, but is not limited to:

-   ABVD Adriamycin (doxorubicin), bleomycin, vinblastine, dacarbazine -   AC Adriamycin (doxorubicin), cyclophosphamide -   BEACOPP Bleomycin, etoposide, Adriamycin (doxorubicin),     cyclophosphamide, Oncovin (vincristine), procarbazine, prednisone -   BEP Bleomycin, etoposide, platinum agent (cisplatin) -   CA Cyclophosphamide, Adriamycin (doxorubicin) (same as AC) -   CAF Cyclophosphamide, Adriamycin (doxorubicin), fluorouracil (5-FU) -   CAV Cyclophosphamide, Adriamycin (doxorubicin), vincristine -   CBV Cyclophosphamide, BCNU (carmustine), VP-16 (etoposide) -   ChIVPP/EVA Chlorambucil, vincristine (Oncovin), procarbazine,     prednisone, etoposide, vinblastine, Adriamycin (doxorubicin) -   CHOP Cyclophosphamide, hydroxydoxorubicin (doxorubicin), vincristine     (Oncovin), prednisone -   CHOP-R or R-CHOP CHOP+rituximab -   COP or CVP Cyclophosphamide, Oncovin (vincristine), prednisone -   CMF Cyclophosphamide, methotrexate, fluorouracil (5-FU) -   COPP Cyclophosphamide, Oncovin (vincristine), procarbazine,     prednisone -   EC Epirubicin, cyclophosphamide -   ECF Epirubicin, cisplatin, fluorouracil (5-FU) -   EP Etoposide, platinum agent (cisplatin) -   EPOCH Etoposide, prednisone, Oncovin, cyclophosphamide, and     hydroxydaunorubicin -   FEC Fluorouracil (5-FU), epirubicin, cyclophosphamide -   FL (Also known as Mayo) Fluorouracil (5-FU), leucovorin (folinic     acid) -   FOLFOX Fluorouracil (5-FU), leucovorin (folinic acid), oxaliplatin -   FOLFIRI Fluorouracil (5-FU), leucovorin (folinic acid), irinotecan -   ICE Ifosfamide, carboplatin, etoposide (VP-16) -   ICE-R ICE+rituximab -   m-BACOD Methotrexate, bleomycin, Adriamycin (doxorubicin),     cyclophosphamide, Oncovin (vincristine), dexamethasone -   MACOP-B Methotrexate, leucovorin (folinic acid), Adriamycin     (doxorubicin), cyclophosphamide, Oncovin (vincristine), prednisone,     bleomycin -   MOPP Mechlorethamine, Oncovin (vincristine), procarbazine,     prednisone -   PCV Procarbazine, CCNU (lomustine), vincristine -   ProMACE-MOPP Methotrexate, Adriamycin (doxorubicin),     cyclophosphamide, etoposide+MOPP -   ProMACE-CytaBOM Prednisone, doxorubicin (adriamycin),     cyclophosphamide, etoposide, cytarabine, bleomycin, Oncovin     (vincristine), methotrexate, leucovorin -   R-FCM Rituximab, fludarabine, cyclophosphamide, mitoxantrone -   Stanford V Doxorubicin, mechlorethamine, bleomycin, vinblastine,     vincristine, etoposide, prednisone -   Thal/Dex Thalidomide, dexamethasone -   TIP Paclitaxel, ifosfamide, platinum agent cisplatin -   VAC Vincristine, Actinomycin, Cyclophosphamide -   VAD Vincristine, Adriamycin (doxorubicin), dexamethasone -   VAPEC-B Vincristine, Adriamycin (doxorubicin), prednisone,     etoposide, cyclophosphamide, bleomycin -   VIP Etoposide, ifosfamide, platinum agent cisplatin

In other embodiments, the therapeutically effective agent is an anti-vial agent. Exemplary anti-viral agents include, but are not limited to, Abacavir, Aciclovir, Acyclovir, Adefovir, Amantadine, Amprenavir, Ampligen, Arbidol, Atazanavir, Atripla, BI201335, Boceprevir, BMS-858 (see, e.g., Gao et al., Nature, 465(6): 96-102 (2010)), BMS-790052 ((see, e.g., Gao et al., Nature, 465(6): 96-102 (2010)), Cidofovir, Combivir, Danoprivir (ITMN-191; RG-7227), Darunavir, Delavirdine, Didanosine, Docosanol, Edoxudine, EI-1 to EI-12 (see, e.g., Baldick et al., PLoS Pathogens, 6(9)e1001086: 1-14 (2010)), Elvitegravir, Efavirenz, Emtricitabine, Enfuvirtide, Entecavir, Etravirine, Famciclovir, Fosamprenavir, Foscarnet, Fosfonet, Ganciclovir, GSK-572, Ibacitabine, Immunovir, Idoxuridine, Imiquimod, Indinavir, Inosine, Interferon (e.g., Interferon type III, Interferon type II, Interferon type I, Peginterferon alfa-2a, Peginterferon alpha-2b, standard interferon alfa-2a, standard interferon alfa-2b, consensus interferon, interferon alfacon-1, ALBUFERON, omega interferon, interferon gamma-1b, lymphoblastoid interferon tau), Lamivudine, Lopinavir, Loviride, Maraviroc, Moroxydine, Methisazon, MK-2048, Nelfinavir, Nevirapine, Nexavir, Oseltamivir (Tamiflu), Penciclovir, Peramivir, Pleconaril, Podophyllotoxin, Raltegravir, Ribavirin, Rimantadine, Ritonavir, Pyramidine, Saquinavir, Stavudine, Tenofovir (e.g., Tenofovir disoproxil), Telaprivir, Tipranavir, Trifluridine, Trizivir, Tromantadine, Truvada, Valaciclovir (Valtrex), Valganciclovir, vaccines (e.g., VZV vaccines such as Varivax and Zostavax), Vicriviroc, Vidarabine, Viramidine, Zalcitabine, Zanamivir (Relenza), Zidovudine, and other small molecule anti-viral agents described, for example, in Herker et al., Nature Medicine, Advance Online Publication doi:10.1038/nm2238: 1-4 (Oct. 10, 2010), and combinations thereof.

Examples of additional anti-viral agents include, but are not limited to, interleukin 2, interleukin 6, interleukin 12, a compound that enhances the development of a type 1 helper T cell response, interfering RNA, anti-sense RNA, Imiqimod, an inosine 5′-phosphate dehydrogenase inhibitor, amantadine and rimantadine.

Other examples include, but are not limited to, those described in WO 2009/023059, the entirety of which is incorporated herein by reference.

In one embodiment, the anti-viral agent is interferon. In another embodiment, the anti-viral agent is telaprivir. In one embodiment, combinations of two or more anti-viral agents are used in further combination with a compound provided herein.

In certain embodiments, the anti-viral agent is a protease inhibitor. Exemplary protease inhibitors include, but are not limited to, Saquinavir, Ritonavir, Indinavir, Nelfinavir, Amprenavir, Lopinavir, Atazanavir, Fosamprenavir, Tipranavir and Darunavir.

In certain embodiments, the anti-viral agent is an integrase inhibitor. Exemplary integrase inhibitors include, but are not limited to, Raltegravir, Elvitegravir and MK-2048, GSK-572.

In certain embodiments, the anti-viral agent is a reverse transcriptase inhibitor (e.g., a nucleoside analog reverse trascriptase inhibitor (NRTI), a nucleotide analog reverse trascriptase inhibitor (NtRTI), a non-nucleoside reverse transcripase inhibitor (NNRTI)).

Exemplary nucleoside analog reverse trascriptase inhibitors (NRTIs) include, but are not limited to, Zidovudine, Didanosine, Zalcitabine, Stavudine, Lamivudine, Abacavir, Emtricitabine, Entecavir and Aciclovir (partial nucleoside structure).

Exemplary nucleotide analog reverse trascriptase inhibitors (NtRTIs) include, but are not limited to, Tenofovir and Adefovir.

Exemplary non-nucleoside reverse transcripase inhibitors (NNRTIs) include, but are not limited to, Efavirenz, Nevirapine, Delavirdine and Etravirine. In certain embodiments, the compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein and/or the anti-viral agent is further used in combination with an enhancing agent. An “enhancing agent”, used in this context, is an agent which, when used in combination with a compound provided herein and/or an anti-viral agent, improves treatment, prevention or management of the microbial infection relative to treatment with the compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein and/or an anti-viral agent without the enhancing agent. Exemplary enhancing agents include, but are not limited to, chloroquine, a quinoline antimalarial, grapefruit juice, hydroxyurea, leflunomide, myucophenolic acid, resveratrol and Ritonavir.

In one embodiment, the anti-viral agent is an anti-viral agent described in U.S. Pub. No. 2011/0064698, which is incorporated herein by reference in its entirety. Exemplary anti-viral agents include, but are not limited to, IP-501, Merimebodib VX-497, IDN-6556, XTL-002, HCV/MF59, CIVACIR, ZADAXIN, CEPLENE, VX 950/LY 570310, ISIS14803, JTK 003, Tarvacin, HCV-796, CH-6, ANA971, ANA245, CPG 10101, Rituximab, NM 283, HepX™-C, IC41, Medusa interferon, E-1, multiferon, BILN 2061, TMC435350, Telaprevir, Boceprevir, ACH-1625, ABT-450, BI-201335, PHX-1766, VX-500, MK-7009, R7227, Narlaprevir, Alinia, ABT-072, ABT-333, Filibuvir, VCH-916, R7128, IDX 184, R7128, R1626, MK-3281, PSI-7851, ANA 598, BI-207127, GS9190, VCH-759, Clemizole, A-832, BMS-790052, ITX 5061, GS-9450, ANA773, CYT 107, SPC3649, Debio 25, SCY-635 and a combination thereof.

Other examples include, but are not limited to, AZD-7295, BI207127, BIT225, BM824383, BMS65032, BMS791325, GS-9256, IDX 375, INX-189, PPI-461, PSI-938, PSI-7977, TMC435, TMC649128, VX-222, VX-759, VX-916 and a combination thereof. These agents are currently in various stages of clinical trials and information is readily available to those in the art.

In one embodiment, provided herein is a method of treating, preventing and/or managing hepatitis C virus (HCV) infection comprising administering a therapeutically or prophylactically effective amount of at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein in combination with one or more other therapeutic agents provided herein.

Examples of such therapeutic agents include compounds having anti-HCV activity, for example, by inhibiting the function of a target such as, but not limited to, HCV metalloprotease, HCV serine protease, HCV polymerase, HCV helicase, SCV NS4B protein, HCV entry, HCV assembly, HCV egress, HCV NS5A protein and IMPDH.

In other embodiments, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can be used in combination with at least one additional therapeutic agent having anti-HCV activity, including, but not limited to, Alinia (Nitazoxanide), Bavituximab, Belerofon, Chronvac-C, Civacir, Clemizole, Fluvastatin, Glycoferon, Hepavaxx C, HuMax-HepC, Lenocta (sodium stibogluconate SSG), Locteron, peginterferon, Ribavirin, Suvus, Telaprevir (VX-950), Zadaxin—thymalfasin, ZALBIN (Albuferon albinterferon alfa-2b), A-837093, ABT-072, ABT-333, ABT-450, ACH-1095, ACH-1625, ACH-2684, ACH-2928, AN 025-1, ANA598, ANA773, ATI-0810 (formerly PG301029), AVL-181, AVL-192, AZD7295, BI 201335, BI 207127, BIT225, BMS-650032, BMS-790052, BMS-791325, BMS-824393, CB5300, CB-183872 (formerly IB657), CF102, CSL123, CTS-1027, CYT107, Debio 025, ECH18, EDP-239, GEA007.1, GI 5005, GNI-103, GNI-104, GS 9190, GS 9256, GSK625433, IC41, ID-12, IDX184, IDX320, IDX375, IMO-2125, IMMU 105, ITMN-191 R7227 (RO5190591), ITX2155, ITX4520, ITX5061NS5A inhibitors, JKB-122, KPE02001003, KPE00001113, MBL-HCV1, MDX-1106 (ONO-4538), Mito-Q, MK-0608, MX3235 Celgosivir, NOV-205, PF-868554, PF-4878691, PHX1766, PYN17, PYN18, PPI-461, PPI-1301, PRO-206, PSI-7977, PSI-9381NX08189, R7128 (RO5024048), REP 9C, RG7348, SCV-07, SCY-635, SD-101, SIRNA-034, SP-30, SPC3649, TG4040, TT033, VCH-759, VX-222, VX-500, VX-813, and VX-985.

In one embodiment, the other therapeutic agent is an interferon. In one embodiment, the interferon is Interferon type III, Interferon type II, Interferon type I, Peginterferon alfa-2a, Peginterferon alpha-2b, standard interferon alfa-2a, standard interferon alfa-2b, consensus interferon, interferon alfacon-1, ALBUFERON, omega interferon, interferon gamma-1b, lymphoblastoid interferon tau or a combination thereof. In another embodiment, the interferon is interferon alfa-2a, interferon alfa-2b, peginterferon alfa-2a, peginterferon alpha-2b, consensus interferon or lymphoblastoid interferon tau.

In another embodiment, the other therapeutic agent is ribavirin.

In another embodiment, at least one compound of formula (I) or a pharmaceutically acceptable form thereof, or a pharmaceutical composition comprising at least one compound of formula (I) or a pharmaceutically acceptable form thereof provided herein can be used in combination with ribavirin and an interferon. In one embodiment, the interferon is Interferon type III, Interferon type II, Interferon type I, Peginterferon alfa-2a, Peginterferon alpha-2b, standard interferon alfa-2a, standard interferon alfa-2b, consensus interferon, interferon alfacon-1, ALBUFERON, omega interferon, interferon gamma-1b, lymphoblastoid interferon tau or a combination thereof. In another embodiment, the interferon is interferon alfa-2a, interferon alfa-2b, peginterferon alfa-2a, peginterferon alpha-2b, consensus interferon or lymphoblastoid interferon tau.

6. Anti-Viral Assays

Anti-viral assays used to screen compounds having efficacy for a specific virus are well-known in the art and described, for example, in WO 2009/023059, the entirety of which is incorporated herein by reference. Exemplary anti-viral assays are provided herein below.

6.1 Herpes Simplex Virus (HSV)

Mouse models of herpes simplex virus type 1 or type 2 (HSV-1 or HSV-2) can be employed to assess the anti-viral activity of test compounds in vivo. BALB/c mice are commonly used, but other suitable mouse strains that are susceptible can also be used. Mice are inoculated by various routes with an appropriate multiplicity of infection of HSV, followed by administration of test compounds and placebo. For i.p. inoculation, HSV-1 replicates in the gut, liver, and spleen and spreads to the CNS. For i.n. inoculation, HSV-1 replicates in the nasaopharynx and spreads to the CNS. Any appropriate route of administration (e.g., oral, topical, systemic and nasal), frequency and dose of administration can be tested to determine the optimal dosages and treatment regimens using test compounds, optionally in combination with other therapies.

In a mouse model of HSV-2 genital disease, intravaginal inoculation of female Swiss Webster mice with HSV-1 or HSV-2 is carried out, and vaginal swabs are obtained to evaluate the effect of therapy on viral replication. (See, e.g., Crute et al., Nature Medicine, 2002, 8:386-391). For example, viral titers by plaque assays are determined from the vaginal swabs. A mouse model of HSV-1 using SKH-1 mice, a strain of immunocompetent hairless mice, to study cutaneous lesions is also described in the art. (See, e.g., Crute et al., Nature Medicine, 2002, 8:386-391 and Bolger et al., Antiviral Res., 1997, 35:157-165). Guinea pig models of HSV have also been described. (See, e.g., Chen et al., Virol. J., 2004 Nov. 23, 1:11). Statistical analysis is typically carried out to calculate significance of the anti-viral activity.

6.2 Human Cytomegalovirus (HCMV)

Since HCMV does not generally infect laboratory animals, mouse models of infection with murine CMV (MCMV) can be used to assay anti-viral activity of test compounds in vivo. For example, a MCMV mouse model with BALB/c mice can be used to assay the anti-viral activities of test compounds in vivo when administered to infected mice, which is described, for example, in Kern et al., Antimicrob. Agents Chemother., 2004, 48:4745-4753. Tissue homogenates isolated from infected mice treated or untreated with test compounds are tested using standard plaque assays with mouse embryonic fibroblasts (MEFs). Statistical analysis is then typically carried out to calculate significance of the anti-viral activity.

Alternatively, human tissue (i.e., retinal tissue or fetal thymus and liver tissue) is implanted into SCID mice, and the mice are subsequently infected with HCMV, preferably at the site of the tissue graft. (See, e.g., Kern et al., Antimicrob. Agents Chemother., 2004, 48:4745-4753). The pfu of HCMV used for inoculation can vary depending on the experiment and virus strain. Any appropriate routes of administration (e.g., oral, topical, systemic and nasal), frequency and dose of administration can be tested to determine the optimal dosages and treatment regimens using test compounds, optionally in combination with other therapies. Implant tissue homogenates isolated from infected mice treated or untreated with test compounds at various time points are tested using standard plaque assays with human foreskin fibroblasts (HFFs). Statistical analysis is then typically carried out to calculate significance of the anti-viral activity.

Guinea pig models of CMV to study anti-viral agents have also been described, for example, in Bourne et al., Antiviral Res., 2000, 47:103-109; Bravo et al., Antiviral Res., 2003, 60:41-49; and Bravo et al, J. Infectious Diseases, 2006, 193:591-597.

6.3 Influenza Virus

Animal models, such as ferret, mouse and chicken, developed for use to test anti-viral agents against influenza virus have been described, for example, in Sidwell et al., Antiviral Res., 2000, 48: 1-16 and McCauley et al., Antiviral Res., 1995, 27: 179-186. For mouse models of influenza, non-limiting examples of parameters that can be used to assay anti-viral activity of test compounds administered to the influenza-infected mice include pneumonia-associated death, serum α1-acid glycoprotein increase, animal weight, lung virus assayed by hemagglutinin, lung virus assayed by plaque assays, and histopathological change in the lung. Statistical analysis is typically carried out to calculate significance of the anti-viral activity.

Nasal turbinates and trachea can be examined for epithelial changes and subepithelial inflammation. The lungs can be examined for bronchiolar epithelial changes and peribronchiolar inflammation in large, medium, and small or terminal bronchioles. The alveoli are also evaluated for inflammatory changes. The medium bronchioles are graded on a scale of 0 to 3+ as follows: 0 (normal: lined by medium to tall columnar epithelial cells with ciliated apical borders and basal pseudostratified nuclei; minimal inflammation); 1+ (epithelial layer columnar and even in outline with only slightly increased proliferation; cilia still visible on many cells); 2+ (prominent changes in the epithelial layer ranging from attenuation to marked proliferation; cells disorganized and layer outline irregular at the luminal border); and 3+ (epithelial layer markedly disrupted and disorganized with necrotic cells visible in the lumen; some bronchioles attenuated and others in marked reactive proliferation).

The trachea is graded on a scale of 0 to 2.5+ as follows: 0 (normal: Lined by medium to tall columnar epithelial cells with ciliated apical border, nuclei basal and pseudostratified. Cytoplasm evident between apical border and nucleus. Occasional small focus with squamous cells); 1+ (focal squamous metaplasia of the epithelial layer); 2+ (diffuse squamous metaplasia of much of the epithelial layer, cilia may be evident focally); and 2.5+ (diffuse squamous metaplasia with very few cilia evident).

Virus immunohistochemistry is performed using a viral-specific monoclonal antibody (e.g., NP-, N- or HN-specific monoclonal antibodies). Staining is graded 0 to 3+ as follows: 0 (no infected cells); 0.5+ (few infected cells); 1+ (few infected cells, as widely separated individual cells); 1.5+ (few infected cells, as widely separated singles and in small clusters); 2+ (moderate numbers of infected cells, usually affecting clusters of adjacent cells in portions of the epithelial layer lining bronchioles, or in small sublobular foci in alveoli); and 3+ (numerous infected cells, affecting most of the epithelial layer in bronchioles, or widespread in large sublobular foci in alveoli).

6.4 Hepatitis Type B Virus (HBV)

A HBV transgenic mouse model, lineage 1.3.46 (official designation, Tg[HBV 1.3 genome] Chi46) has been described previously and can be used to test the in vivo anti-viral activities of test compounds as well as the dosing and administration regimen. (See, e.g., Cavanaugh et al., J. Virol., 1997, 71:3236-3243; and Guidotti et al., J. Virol., 1995, 69:6158-6169). In these HBV transgenic mice, a high level of viral replication occurs in liver parenchymal cells and in the proximal convoluted tubules in the kidneys of these transgenic mice at levels comparable to those observed in the infected liver of patients with chronic HBV hepatitis. HBV transgenic mice that have been matched for age (i.e., 6-10 weeks), sex (i.e., male), and levels of hepatitis B surface antigen (HBsAg) in serum can be treated with test compounds or placebo followed by anti-viral activity analysis to assess the activity of test compounds. Non-limiting examples of assays that can be performed on these mice treated and untreated with test compounds include southern analysis to measure HBV DNA in the liver, quantitative reverse transcriptase PCR (qRT-PCR) to measure HBV RNA in the liver, immunoassays to measure hepatitis e antigen (HBeAg) and HBV surface antigen (HBsAg) in the serum, immunohistochemistry to measure HBV antigens in the liver, and quantitative PCR (qPCR) to measure serum HBV DNA. Gross and microscopic pathological examinations can be performed as needed.

6.5 Human Immunodeficiency Virus (HIV)

The safety and efficacy of test compounds against HIV can be assessed in vivo with established animal models well-known in the art. For example, a Trimera mouse model of HIV-1 infection has been developed by reconstituting irradiated normal BALB/c mice with murine SCID bone marrow and engrafted human peripheral blood mononuclear cells. (See Ayash-Rashkovsky et al., FASEB J., 2005, 19:1149-1151). These mice are injected intraperitoneally with T- and M-tropic HIV-1 laboratory strains. After HIV infection, rapid loss of human CD4.sup.+ T cells, decrease in CD4/CD8 ratio, and increased T cell activation can be observed. A test compound can be administered to these mice and standard assays known in the art can be used to determine the viral replication capacity in animals treated or untreated with the compound. Non-limiting examples of such assays include the COBAS AMPLICOR™ RT-PCR assay (Roche Diagnostics, Branchberg, N.J.) to determine plasma viral load (HIV-1 RNA copies/ml); active HIV-1 virus replication assay where human lymphocytes recovered from infected Trimera mice were cocultured with target T cells (MT-2 cells) and HIV-dependent syncytia formation was examined; and human lymphocytes recovered from infected Trimera mice were cocultured with cMAGI indicator cells, where HIV-1 LTR driven trans-activation of β-galactosidase was measured. Levels of anti-HIV-1 antibodies produced in these mice can also be measured by ELISA. Other established mouse models described in the art can also be used to test the anti-viral activity of test compounds in vivo. (See, e.g., Mosier et al., Semin. Immunol., 1996, 8:255-262; Mosier et al., Hosp. Pract. (Off Ed)., 1996, 31:41-48, 53-55, 59-60; Bonyhadi et al., Mol. Med. Today, 1997, 3:246-253; Jolicoeur et al., Leukemia, 1999, 13:S78-S80; Browning et al., Proc. Natl. Acad. Sci. USA, 1997, 94:14637-14641; and Sawada et al., J. Exp. Med., 1998, 187:1439-1449). A simian immunodeficiency virus (SIV) nonhuman primate model has also been described, for example, in Schito et al., Curr. HIV Res., 2006, 4:379-386.

6.6 In Vitro Screening Assays

6.6.1 General Procedures for Assays for Herpes Viruses

To quickly screen out samples that do not have activity against any of the herpes viruses, or are too toxic to evaluate, an inexpensive, rapid assay such as a CPE-inhibition assay that is semi-automated is commonly used initially to screen out the negatives. Typically, all screening assays are conducted in low passage human cells, and each assay system contains a positive control (ACV, GCV, CDV) and a negative control (AZT). Efficacy is demonstrated by at least two different assay systems that detect functional biologic activity and should be confirmed using low passaged clinical isolates and drug resistant mutants whenever available. In the case of EBV, efficacy against EBV is confirmed using a hybridization assay that quantifies DNA synthesis. Toxicity is determined using both resting and proliferating human fibroblast cells and proliferating lymphoblastic cells, and for selected compounds, toxicity in human myeloid and erythroid progenitor cells is assessed.

6.6.1.1 HSV-1, HSV-2, CMV and VZV

All the screening assay systems utilized are selected to show specific inhibition of a biologic function, i.e., cytopathic effect (CPE) in susceptible human cells. In the CPE-inhibition assay, a test compound is added 1 hour prior to infection so the assay system will have maximum sensitivity and detect inhibitors of early replicative steps, such as adsorption or penetration, as well as later events. To rule out non-specific inhibition of virus binding to cells, all compounds that show reasonable activity in the CPE assay are confirmed using a classical plaque reduction assay in which the compound is added 1 hour after infection. In the case where a compound blocks attachment, a positive result will appear in the CPE assay, but may be negative by plaque assay. In this case, the plaque assay is repeated with compound being added prior to viral infection. These assay systems also can be manipulated by increasing the pretreatment time in order to demonstrate anti-viral activity with oligodeoxynucleotides and/or peptides and by delaying addition of drug after infection. Information regarding which step in the virus life cycle is inhibited (i.e., early vs. late functions) can be gained.

In all the assays used for primary screening, a minimum of six compound concentrations is contemplated to cover a range of, e.g., 100 μg/ml to 0.03 μg/ml, in 5-fold increments to determine efficacy. Dose response curves are obtained from these data. The dose that inhibits viral replication by 50% (effective concentration 50; EC₅₀) is typically calculated using a computer software program, for example, MacSynergy II by M. N. Prichard, K. R. Asaltine, and C. Shipman, Jr., University of Michigan, Ann Arbor, Mich.

The same compound concentrations used to determine efficacy are also used on uninfected cells in each assay to determine toxicity of each experimental compound. The compound concentration that is cytotoxic to cells as determined by their failure to take up a vital stain, neutral red (cytotoxic concentration 50; CC₅₀), is determined as described above.

In some embodiments, compounds to treat herpes virus infections are for systemic diseases, such as neonatal herpes, CMV, and disseminated VZV, and may need to be given parenterally. Therefore, the toxicity of test compounds on dividing cells is determined at a very early stage of testing. In this regard, a cell proliferation assay using HFF cells can be a very sensitive assay for detecting compound toxicity to dividing cells, and the compound concentration that inhibits cell growth by 50% (IC₅₀) can be calculated as described above. In comparison with four human diploid cell lines and vero cells, HFF cells are the most sensitive and predictive of toxicity for bone marrow cells.

To determine if each compound has sufficient anti-viral activity that exceeds its level of toxicity, a selectivity index (SI) is calculated according to CC₅₀/EC₅₀. This index, also referred to as a therapeutic index, is used to determine if a compound warrants further study. Typically, a compound that had an SI of 10 or greater is evaluated in additional assay systems.

For HSV-1 and HSV-2, compounds that show activity in the CPE-inhibition assay are confirmed using the plaque reduction assay. Susceptibility of additional virus strains, including both lab passaged and clinical isolates, is determined for selected compounds. A battery of ACV resistant HSV strains can be also utilized. For CMV, compounds that show activity in the CPE-inhibition assay are confirmed using the plaque reduction assay in HFF cells. A variety of laboratory, clinical, and GCV resistant isolates are also available for testing. For VZV, compounds with activity in a CPE assay are evaluated further in a plaque reduction assay.

6.6.1.2 Epstein-Barr Virus (EBV)

The initial system to be used to determine anti-viral activity against EBV can be VCA production in Daudi cells using an ELISA assay. Six concentrations of drug covering a range of, e.g., 50 μg/ml to 0.03 μg/ml are utilized. Using the results obtained from untreated and drug treated cells, an EC₅₀ can be calculated. Selected compounds that have good activity against EBV VCA production without toxicity are tested for their ability to inhibit EBV DNA synthesis.

In each assay system utilized, drug treatment of uninfected cells is incorporated to obtain as much toxicity data as possible. In some embodiments, for calculation of the SI, the data on toxicity is at least as reliable as the results for efficacy. An example of a toxicity assay is a colormetric method using MTS.

All compounds that have an SI of, for example, greater than 10 in the screening assay are confirmed in a hybridization assay that measures the amount of EBV DNA produced by P3HR-1 infected cells. A wide range of compound concentrations can be utilized so an accurate EC₅₀ can be calculated. Uninfected control cells treated with compound are also utilized as another measure of drug toxicity. In some cases, it is possible that results obtained using assays for VCA production and DNA synthesis may not correlate since the two events may be independent.

6.6.1.3 Human Herpes Virus HHV-6 and HHV-8

Cord Blood Lymphocytes (CBL) and the Human T cell lymphoblastoid lines, HSB-2 and SupT-1, are used in screening assays for HHV-6. CBL are isolated from fresh heparinized umbilical cord blood and are infected with the Z29 strain of HHV-6. The body cavity based B-cell lymphoma cell line, BCBL-1, are used for screening against HHV-8.

There are two variants of HHV-6 known as type A variants or type B variants. The HHV-6 type A variant is, for example, the GS strain which is propagated in HSB-2 or SupT-1 cells. The HHV-6 type B variant is, for example, Z29 (ATCC, Rockville, Md.) which is grown as a stock in CBL. The HHV-8 is propagated in a latent state in the BCBL-1 cell line. Lytic growth of the HHV-8 can be induced by the addition of the phorbol ester, TPA.

Six concentrations of each drug ranging from, e.g., 100 μg/ml to 0.03 μg/ml drug are tested to obtain the EC₅₀, EC₉₀, CC₅₀, and IC₅₀ values. The initial assay for HHV-6 is a flow cytometric analysis of HHV-6 antigens in either HSB-2 cells (HHV-6A), CBL (HHV-6B), or SupT-1 (6A or 6B). For HHV-8, yytic infection of virus in BCBL-1 cells will be carried out as described above. The initial assay for HHV-8 is a flow cytometric analysis of HHV-8 antigens in BCBL-1 cells. As with the other herpes virus assays, these assays contain the positive (infected and untreated cells) and negative (uninfected or uninduced and compound treated cells) controls needed for effective analysis and cytotoxicity determinations.

6.6.2 In Vitro Laboratory Procedures for Assays for Herpes Viruses

6.6.2.1 Efficacy Screening for HSV-1, HSV-2, CMV and VZV

Preparation of Human Foreskin Fibroblast Cells:

Newborn human foreskins can be obtained from the University of Alabama School of Medicine (UAB) or Brookwood Hospital, Birmingham, Ala., as soon as possible after circumcisions are performed and placed in minimal essential medium (MEM) containing vancomycin, fungizone, penicillin, and gentamicin, at the usual concentrations, for four hours at room temperature. The medium is then removed, the foreskin minced into small pieces and washed repeatedly until red cells are no longer present. The tissue is then trypsinized using trypsin at 0.25% with continuous stirring for 15 minutes at 37° C. in a CO₂ incubator. At the end of each 15 minute period, the tissue is allowed to settle to the bottom of the flask. The supernatant containing cells is poured through sterile cheesecloth into a flask containing MEM and 10% fetal bovine serum (FBS). The flask containing the medium is kept on ice throughout the trypsinizing procedure. After each decanting of cells, the cheese cloth is washed with a small amount of MEM containing serum. Fresh trypsin is added each time to the foreskin pieces and the procedure repeated until no more cells become available. The cell-containing medium is then centrifuged at 1000 RPM at 4° C. for 10 minutes. The supernatant liquid is discarded and the cells are resuspended in a small amount of MEM with 10% FBS. The cells are counted using a Coulter Counter and then placed in an appropriate number of 25 cm² tissue culture flasks. As cells become confluent and need trypsinization, they are gradually expanded into 175 cm² flasks. The cells are maintained on vancomycin and fungizone to passage three. Cell lines are tested periodically for the presence of mycoplasma contamination using the Hoechst fluorescent stain for mycoplasma DNA. Cells are utilized usually only until passage 10.

Cytopathic Effect Inhibition Assay:

Low passage (3-10) human foreskin fibroblast (HFF) cells are trypsinized, counted, and seeded into 96 well tissue culture plates at a cell concentration of 2.5×10⁴ cells in 0.1 ml of MEM supplemented with 10% FBS. The cells are then incubated for 24 hours at 37° C. in a 5% CO₂-95% air, 90% humidified atmosphere. The media is then removed and 100 μl of MEM containing 2% FBS is added to all but the first row. In the first row, 125 μl of media containing the experimental compound is added in triplicate wells. Media alone is added to both cell and virus control wells. The compound in the first row of wells is then diluted serially 1:5 throughout the remaining wells by transferring 25 μl using a Beckman Bio-Mek Liquid Handling Machine. The plates are then incubated for 60 minutes and 100 μl of an appropriate virus concentration added to each well, excluding cell control wells which received 100 μl of MEM. For HSV-1 and HSV-2 assays, the virus concentration utilized is 1000 Plaque Forming Units (PFU) per well. For CMV and VZV assays, the virus concentration added is 2500 and 1000 PFU per well, respectively. The plates are then incubated at 37° C. in a CO₂ incubator for three days for HSV-1 and HSV-2, 10 days for VZV, or 14 days for CMV. After the incubation period, the media is aspirated and the cells are stained with a 0.1% crystal violet in formalin solution for 4 hours. The stain is then removed and the plates rinsed using tap water until all excess stain is removed. The plates are allowed to dry for 24 hours and the amount of CPE in each row determined using a BioTek Multiplate Autoreader. EC₅₀ and IC₅₀ values are determined by comparing compound treated and untreated cells using a computer program.

Plaque Production Assay for HSV-1 and HSV-2:

Two days prior to use, HFF cells are trypsinized, counted, and plated into six well plates and incubated at 37° C. with 5% CO₂ and 90% humidity. On the date of assay, the compound is made up at twice the desired concentration in 2×MEM and then serially diluted 1:5 in 2×MEM to give six concentrations of compound. The compound concentrations utilized are usually 200 μg/ml down to 0.06 μg/ml. The virus to be used is diluted in MEM containing 10% FBS to a desired concentration which will give 20-30 plaques per well. The media is then aspirated from the wells and 0.2 ml of virus is added to each well in triplicate with 0.2 ml of media being added to drug toxicity wells. The plates are then incubated for 1 hour with shaking every 15 minutes. After the incubation period, an equal amount of 1% agarose is added to an equal volume of each compound dilution. This provides final compound concentrations beginning with 100 μg/ml and ending with 0.03 μg/ml and a final agarose overlay concentration of 0.5%. The compound agarose mixture is applied to each well in a 2 ml volume and the plates are incubated for three days, after which the cells are stained with a 1.5% solution of neutral red. At the end of the 4-6 hours incubation period, the stain is aspirated, and plaques counted using a stereomicroscope at 10× magnification.

Plaque Production Assay for CMV:

The procedures are nearly identical to those provided for HSV with a few minor changes. The agarose used for both the initial overlay and the two subsequent overlays is 0.8% rather than 1%. The assay is incubated for 14 days with the additional 1 ml overlays being applied on days 4 and 8.

Plaque Production Assay for VZV:

The procedures are essentially identical to those described for the HSV plaque assay with the following possible exceptions: after addition of the compound, the plates are incubated for ten days; on days 3 and 6, an additional 1 ml overlay with equal amounts of 2×MEM and 1% agarose are added.

Plaque Reduction Assay:

In certain cases, some large or highly charged molecules that are active in the CPE inhibition assay may be inactive in the plaque assay because the compound failed to diffuse through the agarose overlay. Therefore, a modified plaque assay can be used for confirmation, wherein the overlay medium is liquid rather than semi-solid. The procedure for the liquid overlay plaque assay is similar to that using the agarose overlay. The procedure for adding the virus is the same as for the regular plaque assay. The compounds are made up at the desired concentrations in MEM with 2% FBS. For HSV-1 and HSV-2 assays, an antibody preparation obtained from, e.g., Baxter Health Care Corporation is diluted 1:500 and added to the media that the compound is diluted in to limit extracellular spread of virus through the media. For VZV and CMV, no antibody in the overlay is necessary. For the CMV and VZV assays, additional medium without the new compound is added on day five and allowed to incubate for a total of 8 and 10 days, respectively. At the end of the incubation period for all of the assays, 2 ml of a 6.0% neutral red solution is added to each well and incubated for 6 hours. The liquid is then aspirated off and plaques enumerated using a stereomicroscope.

6.6.2.2 Efficacy Screening for EBV

Cells:

The two lymphoid cell lines, Raji and Daudi derived from Burkitt's lymphoma, are used. The Raji cell line is a non-producer of viral gene products associated with the productive viral cycle. The Daudi cell line is a low level producer, i.e., fewer than 1% of the cells express EA spontaneously. These cells are equally susceptible to superinfection by the P3HR-1 virus as determined by EBV VCA expression. The cells are maintained at 37° C. in a humidified atmosphere with 5% CO₂, in culture with RPMI-1640 medium containing 10% heat inactivated FBS, 100 u/ml Penicillin, 25 μg/ml gentamicin and 2 mM L-glutamine. The cells are passaged twice weekly and the cell concentration adjusted to 2×10⁶/ml for use.

Virus:

The following prototypes of infectious EBV can be used: (1) one derived from supernatant fluids of the P3HR-1 cell line, which produces non-transforming virus that induces the production of VCA after primary infection or superinfection of B cell lines; and (2) B95-8 virus, which immortalizes cord blood lymphocytes and induces tumors in marmosets, but does not induce an abortive productive infection even in cell lines harboring EBV genome copies. As an example, for virus production, P3HR-1 cells are cultured at a concentration of 2×10⁵/ml for two weeks in medium containing 2% FCS at 34° C. in a humidified atmosphere with 5% CO₂. Concentrated virus then is prepared from the supernatant of the culture by centrifugation at 12,000 g for 90 minutes in a Sorvall Centrifuge. The pellets are resuspended in RPMI-1640 medium at 1/100 of the original volume and stored at −70° C.

Antibodies:

Murine monoclonal antibody to EBV VCA (Chemicon International, Inc., Temecula, Calif.), is used in immunofluorescence assays and ELISA. Optimal monoclonal antibody concentration is determined by antibody titration for each assay system. For single fluorochrome analyses FITC-labelled goat anti-mouse total IgG (Southern Biotechnology Associates, Birmingham, Ala.) is used as the second antibody.

EBV Superinfection and Compound Treatment:

Superinfection is initiated by the incubation of 0.5 ml of an appropriate concentration of EBV with 106 cells/tube in a total of 1 ml/tube. In most cases, this amounts to a multiplicity of infection (MOI) of 0.1-0.2 based on VCA induction in Daudi cells. After adsorption at 37° C. for 1 hour, 3 ml of RPMI-1640 medium is added. The cells are pelleted by centrifugation and supernatants discarded. Compound concentrations (0.08, 0.4, 2, 10, 50 μg/ml) in 4 ml of RPMI-1640 are added to the appropriate tubes. RPMI-1640 is added to positive and negative control tubes and each compound concentration is added to Daudi cells without virus for toxicity controls. After incubation, the cells in each tube are counted using a Coulter Counter and washed three times with phosphate buffered saline solution (PBS) (without Ca and Mg). Each cell suspension is adjusted to a concentration of 4.0×10⁶ cells/ml in PBS. For EBV IFA and DNA hybridization assays, two sets of slides are prepared with 4×10⁴ cells/spot for each cell suspension, and air-dried overnight.

Immunifluorescence Assay:

The infected and compound treated cells are counted and washed three times with PBS. Cells, 4×10⁴ in PBS, are spotted on multiwell slides and air dried. The cells are then fixed for 10 minutes in acetone, washed in PBS and stained for immunofluorescence with the mouse monoclonal antibodies and FITC-labeled goat anti-mouse IgG. EBV VCA specific antibodies are used in the immunofluorescence assays. FITC-labeled goat anti-mouse IgG (Southern Biotechnology Associates, Birmingham, Ala.) is used as the second antibody. The slides are counterstained with 0.1% Evan's blue for 5 minutes and mounted with 10% glycerin in PBS. The number of FITC-positive cells on each smear is determined using a Nikon fluorescence microscope. Five hundred cells are counted in each spot. The number of cells expressing EBV VCA is calculated by multiplying the fraction of antigen positive cells by the number of cells/ml in the culture at the time of harvest. The compound concentration is plotted against the number of antigen positive cells/ml using a computer program, and EC₅₀ and EC₉₀ values are calculated.

ELISA:

Daudi cells infected with P3HR-1 virus and treated with drug are harvested by centrifugation and washed three times with PBS. The cells are pelleted and suspended to a concentration of 4×10⁶ cells/ml in PBS. One hundred μl of each suspension is dispensed in triplicate into a 96-well plate, air-dried and fixed with 95% ethanol and 5% acetic acid. Uninfected cells are prepared in the same manner and used as controls. After washing the plate, primary and secondary antibodies diluted in 1% bovine serum albumin containing 0.05% Tween-20 are added sequentially to each well and incubated at room temperature. Antibody additions are separated by 3 washes with PBS containing 0.005% Tween-20. O-phenyldiamine (OPD) substrate is added and the reaction stopped with 3N H₂SO₄ after about 10 minutes. The optical density is measured at 492 nm and the EC₅₀ extrapolated using the computer software program described herein.

Evaluation of Anti-viral Agents against EBV DNA Replication:

The Enzo Simply Sensitive Horseradish Peroxidase-AEC In Situ Detection System for EBV (Enzo Diagnostics, Farmingdale, N.Y.) is used to determine anti-viral activity against DNA synthesis. Detection and staining are performed according to the manufacturer's instructions. Three days after superinfection and compound treatment, slides are prepared with 4×10⁴ cells/spot for each cell suspension, and air-dried overnight. The slides are fixed in acetone for 10 minutes. A biotin labelled EBV probe is added to each spot of fixed cells and the slide is covered with a glass coverslip. The slide is then heated on a hot plate at 95° C. for 5 minutes. After heating, the slide is placed at 37° C. on a slide warmer for 30-60 minutes for the DNAs to anneal. The coverslips are then removed and the Post Hybridization Reagent is added to each spot. After incubation for 10 minutes and rinsing with washing buffer, Detection Reagent is applied. The Detection Reagent is left on the slide for 30-60 minutes on a slide warmer and then washed off with washing buffer. Chromogen Substrate Solution is added and incubated for 20 minutes on a slide warmer. The slides are washed and counter stained with Blue Counterstain. The slides are then rinsed with deionized water and mounted with water. The slides are viewed in a light microscope under a magnification of 400×. Positive cells appear as red spots. All the cells are counted in several fields. The fraction of red spots in the total number of cells counted multiplied by 100 reflects the percent hybridization.

Primary Infection Assay:

The primary infection of umbilical cord blood lymphocytes with the transforming strain B95-8 of EBV induces the expression of the virus-associated nuclear antigen (EBNA) in the cell. It is also known that B95-8 virus induces cellular DNA synthesis after infection of CBL. The availability of EBNA virus-infected cells in culture allows for the identification and quantitation of EBV-positive cell antigens by indirect IFA staining and FACS. Cord blood lymphocytes separated by ficoll-hypaque gradient are cultured in complete RPMI-1640. The EBV-B95-8 is produced by incubating the B95-8 cell line in RPMI-1640 plus 10% fetal calf serum for 10-14 days. The supernatant is collected and stored at 0-4° C. One million CBL are infected by incubation with 1 ml of the B95-8 supernant for 1 hour. The virus is removed by centrifugation. After one wash with RPMI-1640, the infected cells are treated with anti-viral compounds as described earlier for P3HR-1 superinfection. The cell cultures are incubated for 4-6 days. Cell harvesting and immunofluorescent staining is the same as described above.

6.6.2.3 Efficacy Screening for HHV-6 and HHV-8

Cord Blood Lymphocytes (CBL) Cells:

Fresh heparinized umbilical cord blood can be obtained, e.g., from the University of Alabama at Birmingham Hospital, and diluted 1:1 with Hank's balanced salt solution and layered on a Histopaque 1077 (Sigma Chemical Co., St. Louis, Mo.) gradient. The tubes are centrifuged at 1600 rpm for 30 minutes at room temperature and serum is carefully aspirated off. The lymphocytes are removed, washed with Hank's balanced salt solution and centrifuged at 1200 rpm for 10 minutes. The supernatant is aspirated, and the cells are resuspended in RPMI 1640 containing 10% heat-inactivated FBS, 2 mM L-glutamine, 100 U/ml penicillin, 0.25 μg/ml fungizone, 25 μg/ml gentamicin, 0.1 U/ml Interleukin-2 (Sigma, St. Louis, Mo.) and 0.5 μg/ml Phaseolus Vulagaris agglutinin protein (PHAP). CBLs are used in the HHV-6, Z-29 (Variant B) assays.

Human T Cell Lymphoblastoid Line HSB-2:

The HSB-2 cells can be obtained through, e.g., the NIH AIDS Research and Reference Reagent Program (Rockville, Md.), and are propagated in RPMI 1640 containing 10% heat-inactivated FBS, 100 U/ml penicillin, 25 μg/ml gentamicin and 2 mM L-glutamine. The cells are split 1:5 in a 175 cm² flask every 3-4 days and used in the HHV-6, GS (Variant A) assays.

Body Cavity-Based Lymphoma (BCBL-1) Cells:

BCBL-1 cells (NIH AIDS Research and Reference Program, Rockville, Md.) propagated in RPMI 1640 media containing 10% FBS, 2 mM L-Glutamine, 10 μM β-Mercaptoethanol 100 μ/l penicillin, and 25 μg/ml gentamicin are utilized in the HHV-8 assay.

Viruses:

There are two variants of HHV-6 known as type A variants or type B variants. An example of HHV-6 type A variant is the GS strain which is propagated in the HSB-2 cells and can be obtained through, e.g., the AIDS Research and Reference Reagent Program, Division of AIDS, NIAID, NIH. These cells, referred to as HSB-2/HHV-6GS, are maintained at 5×10⁵ cells/ml under the same conditions and in the same media as the uninfected HSB-2 cells. The cells are split every 3-4 days by addition of uninfected cells at 9 parts to 1 part infected cells. Stock titers of this virus of 1×10⁵ both in cell-associated and cell-free virus can be obtained by growth for 5 days. An example of HHV-6 type B variant is Z29 (ATCC, Rockville, Md.) which is grown as a stock in CBL by incubation for 10 days followed by collection, centrifugation and freezing of the supernatant. HHV-8, latently expressed in the primary effusion lymphoma derived BCBL-1 cell line (NIH AIDS Research and Reference Program, Rockville, Md.) is induced into lytic HHV-8 expression by addition of 100 ng/ml phorbol 12-myristate 13-acetate. BCBL-1 cells are cultured in RPMI 1640 media containing 10% FBS, 2 mM L-glutamine, 10 μM β-mercaptoethanol 100 U/ml penicillin and 25 μg/ml gentamicin.

Primary Antibodies:

The primary antibodies used for the indirect IFA and FACS are selected for their antigen specificity, low cross-reactivity with other herpes viruses and fluorescence intensity as monitored by FACS. Monoclonal antibodies selected for use in the HHV-6 assay systems are screened for variant specificity and demonstrated no A or B variant cross-reactivity in the assay systems. Monoclonal antibody 8532 (Chemicon, Temecula, Calif.) targets HHV-6 induced early nuclear proteins and is used as a primary antibody in the HHV-6GS assay systems at a 5 μg/ml concentration. Monoclonal antibody 8535 (Chemicon, Temecula, Calif.) which targets a B variant 101 kDa virion protein is used as a primary antibody in the HHV-6Z-29 assay system at a 5 μg/ml concentration. The HHV-8 monoclonal antibody KS8.1 (Bala Chandran, University of Kansas Department of Microbiology, Molecular Genetics and Immunology) targets the HHV-8 viral envelope associated glycoprotein 8.1 expressed in the late lytic phase of HHV-8 replication (Zoeteweij et al., 1999) and is used at approximately 5 μg/ml. Monoclonal antibody to the EBV VCA glycoprotein 125 (Chemicon, Temecula, Calif.) is used at a concentration of 2.5 μg/ml for ELISA and 5 μg/ml for IFA.

Efficacy Against HHV-6:

Serial 5-fold dilutions of drug starting at 50 μg/ml are prepared in media. CDV is used as a positive control. Samples for determining anti-viral efficacy are prepared by incubating 1×10⁶ cells for one hour with sufficient virus to infect approximately 35% of the cells. After infection, the appropriate dilution of compound is added and cells incubated for 4 to 6 days at 37° C. Virus free controls are prepared by incubating 1×10⁶ cells in compound-free media for the designated period and virus controls are prepared by incubating 1×10⁶ cells for one hour with sufficient virus to infect 35% of the cells followed by incubation in compound-free media for the designated period. After incubation, the cells are rinsed with PBS and permeabilized overnight in methanol at −80 C for use in FACS.

FACS Assay: Cells are rinsed thoroughly with PBS and a blocking solution containing 5% FBS, 4% Normal goat serum (NGS) and 0.5% DMSO. Cells are then incubated with the appropriate monoclonal antibody (HHV-6 early nuclear proteins (Chemicon, Temecula, Calif.) for HHV-6, GS variant A, a 101 kDa virion protein (Chemicon, Temecula, Calif.) for HHV-6, Z-29 variant B, and KS8.1 for HHV-8 (Bala Chandran, University of Kansas, Department of Microbiology, Molecular Genetics and Immunology).

6.6.2.4 Toxicity Screening for Herpes Viruses

Neutral Red Uptake Assay—HFF Cells:

Twenty-four hours prior to assay, HFF cells are plated into 96 well plates at a concentration of 2.5×10⁴ cells per well. After 24 hours, the media is aspirated and 125 μl of each compound concentration is added to the first row of wells and then diluted serially 1:5 using the automated Bio-Mek Liquid Handling System in a manner similar to that used in the CPE assay. The plates are then incubated in a CO₂ incubator at 37° C. for seven days. At this time the media/compound is aspirated and 200 μl/well of 0.01% neutral red in DPBS is added. This mixture is incubated in the CO₂ incubator for 1 hour. The compound is aspirated and the cells are washed using a Nunc Plate Washer. After removing the DPBS wash, 200 μl/well of 50% ETOH/1% glacial acetic acid (in H₂O) is added. The plates are rotated for 15 minutes and the optical densities are read at 550 nm on a plate reader. CC₅₀ values are calculated using a computer program.

Cell Proliferation Assay—HFF Cells:

Twenty-four hours prior to assay, HFF cells are seeded in 6-well plates at a concentration of 2.5×10⁴ cells per well in MEM containing 10% FBS. On the day of the assay, test compounds are diluted serially in MEM containing 10% FBS at increments of 1:5 covering a range from 100 μg/ml to 0.03 μg/ml. For compounds that have to be solubilized in DMSO, control wells receive MEM containing 1.0% DMSO. The media from the wells is then aspirated and 2 ml of each compound concentration is then added to each well. The cells are then incubated in a CO₂ incubator at 37° C. for 72 hours. At the end of this time, the media-compound solution is removed and the cells are washed. One ml of 0.25% trypsin is added to each well and incubated until the cells start to come off of the plate. The cell-media mixture is then pipetted up and down vigorously to break up the cell suspension, and 0.2 ml of the mixture is added to 9.8 ml of Isoton III and counted using a Coulter Counter. Each sample is counted 3 times with 2 replicate wells per sample.

MTS Tetrazolium Cytotoxicity Assay:

Serial 5-fold dilutions of test compound starting at 50 μg/ml are prepared in media and added to 1×10⁶ cells. Controls are prepared by incubating 1×10⁶ cells in compound-free media. After an incubation period of 3-6 days depending on the assay system, 200 μl is transferred to a 96 well plate in duplicate. 20 μl of MTS is added, and the plate is wrapped in foil and incubated at 37° C. for 4 hours. MTS is bioreduced by dehydrogenase enzymes found in metabolically active cells into an aqueous soluble formazan. The quantity of formazan product as measured by the amount of 490 nm absorbance is directly proportional to the number of living cells in culture. Compound concentration is plotted against the optical density of each sample and CC₅₀ values were calculated using MacSynergy II.

Cell Proliferation Assay—HSB-2 and Daudi Cells:

Serial 5-fold dilutions of compound starting at 50 μg/ml are prepared in media and added to 1×10⁶ cells. Controls are prepared by incubating 1×10⁶ cells in compound-free media. After an incubation period of 3-4 days depending on the assay system, a Coulter Counter is used to determine the total number of cells for each sample (HSB-2 and Daudi cell lines). Compound concentration is plotted against the total concentration of cells for each sample and IC₅₀ values are calculated using MacSynergy II.

Bone Marrow Assay:

In vitro toxicity can be determined by inhibition of myeloid [colony-forming units granulocyte/macrophage (CFU-GM)] and erythroid [burst-forming unit-erythroid (BFU-E)] colony formation in soft agar clonal assays. Using a 21-23 gauge needle attached to a syringe, rodent bone marrow cells are collected from the leg bone of rats or mice by flushing with Isocoves' Modified Dulbecco's medium (IMDM). A single cell suspension is obtained by repeated aspiration through the needle. Nucleated cells are enumerated with a hemacytometer and adjusted to the desired cell concentration in IMDM. Murine CFU-GM assays are prepared with 2.5×10⁵ nucleated cells/ml, 20% FBS, 10 ng/ml rmGM-CSF, and 0.2% agarose. BFU-E cultures include 30% FBS, 1% deionized BSA, 0.1 mM 2-ME, 4 U/ml rhEpo, 10 ng/ml rmIL-3, 2.5×10⁵ nucleated cells/ml and 0.2% agarose (140). Triplicate wells (in 6 well plates) containing 0.1 ml of compound (10×) receive 1 ml of either culture mixture for each concentration group and slowly mixed. The cultures are allowed to gel at 4° C. and then incubated for 7 (CFU-GM) or 9 (BFU-E) days at 37° C. in a humidified atmosphere of 5% CO₂ in air. Colonies are counted using an inverted microscope. CFU-GM colonies are identified as cell clones containing at least 40 cells. BFU-E cultures are stained with dianisidine, and aggregates of greater than 60 hemoglobin-containing cells are counted as erythroid colonies. The median inhibitory concentration (IC₅₀) and the 90% inhibitory concentration (IC₉₀) are derived from linear regression analysis of the logarithm of compound concentration versus CFU-GM or BFU-E survival fraction.

6.6.3 In Vitro Laboratory Procedures for Assays for Influenza, Respiratory and Other Viruses

6.6.3.1 Screening Efficacy for RSV, PIV and Flu, Measles, Rhino, Adeno, SARS, VEE, Yellow Fever, West Nile, Pichinde, Punta Toro and Dengue Viruses

Rapid Screening Assay:

When relatively large numbers (10 or more) of test compounds are available, the compounds are evaluated in a 2-concentration test. In this procedure, two concentrations (e.g., 200 and 20 μg/ml) are tested. Compounds are diluted 1:2 when virus is added, making final concentrations 100 and 10 μg/ml. The standard CPE test uses an 18 hour monolayer (80-100% confluent) of the appropriate cells, medium is drained and each of the concentrations of test compound or placebo are added, followed within 15 minutes by virus or virus diluent. Two wells are used for each concentration of compound for both anti-viral and cytotoxicity testing. The plate is sealed and incubated the standard time period required to induce near-maximal viral CPE. The plate is then stained with neutral red by the method described below, and the percentage of uptake indicating viable cells read on a microplate autoreader at dual wavelengths of 405 and 540 nm, with the difference taken to eliminate background. An approximated virus-inhibitory concentration, 50% endpoint (EC₅₀) and cell-inhibitory concentration, 50% endpoint (IC₅₀) are determined from which a general selectivity index is calculated: SI=(IC₅₀)/(EC₅₀). An SI of 3 or greater typically indicates confirmatory testing is needed.

Inhibition of Cytopathic Effect (CPE):

This test, run in 96 well flat-bottomed microplates, is used for the initial anti-viral evaluation of all new test compounds. In this CPE inhibition test, four log₁₀ dilutions of each test compound (e.g., 1000, 100, 10, 1 μg/ml) are added to 3 cups containing the cell monolayer; within 5 minutes, the virus is then added and the plate sealed, incubated at 37° C. and CPE read microscopically when untreated infected controls develop a 3 to 4+ CPE (approximately 72 to 120 hours). A known positive control compound is evaluated in parallel with test compounds in each test. The positive control compound, for example, is: ribavirin for dengue, influenza, measles, RSV, PIV, Pichinde, Punta Toro and VEE viruses; cidofovir for adenovirus; pirodovir for rhinovirus; 6-azauridine for West Nile and yellow fever viruses; and alferon (interferon alfa-n3) for SARS virus. Follow-up testing with compounds that are found active in initial screening tests are run in the same manner except 8 one-half log₁₀ dilutions of each compound are used in 4 cups containing the cell monolayer per dilution. The data are expressed as 50% effective concentrations (EC₅₀).

Increase in Neutral Red (NR) Dye Uptake:

This test is run to validate the CPE inhibition seen in the initial test, and utilizes the same 96-well micro plates after the CPE has been read. Neutral red is added to the medium; cells not damaged by virus take up a greater amount of dye, which is read on a computerized micro plate autoreader. For example, the method as described by McManus, Appl. Environment. Microbiol. 1976, 31:35-38, can be used. An EC₅₀ is determined from this dye uptake.

Decrease in Virus Yield:

Compounds considered active by CPE inhibition and by NR dye uptake are re-tested if additional, fresh material is available, using both CPE inhibition and, using the same plate, the effect on reduction of virus yield by assaying frozen and thawed eluates from each cup for virus titer by serial dilution onto monolayers of susceptible cells. Development of CPE in these cells is the indication of presence of infectious virus. As in the initial tests, a known active compound is run in parallel as a positive control. The 90% effective concentration (EC₉₀), which is that test compound concentration that inhibits virus yield by 1 log 10, is determined from these data.

6.6.3.2 Screening Toxocity for RSV, PIV and Flu, Measles, Rhino, Adeno, SARS, VEE, Yellow Fever, West Nile, Pichinde, Punta Toro and Dengue Viruses

Visual Observation:

In the CPE inhibition tests, two wells of uninfected cells treated with each concentration of test compound are run in parallel with the infected, treated wells. At the time CPE is determined microscopically, the toxicity control cells are also examined microscopically for any changes in cell appearance compared to normal control cells run in the same plate. These changes can be enlargement, granularity, cells with ragged edges, a filmy appearance, rounding, detachment from the surface of the well, or other changes. These changes are given a designation of T (100% toxic), PVH (partially toxic—very heavy—80%), PH (partially toxic—heavy—60%), P (partially toxic—40%), Ps (partially toxic—slight—20%), or 0 (no toxicity—0%), conforming to the degree of cytotoxicity seen. A 50% cell inhibitory (cytotoxic) concentration (IC₅₀) is determined by regression analysis of these data.

Neutral Red Uptake:

In the neutral red dye uptake phase of the anti-viral test described above, the two toxicity control wells also receive neutral red and the degree of color intensity is determined spectrophotometrically. A neutral red IC₅₀ (NR IC₅₀) is subsequently determined.

Viable Cell Count:

Compounds considered to have significant anti-viral activity in the initial CPE and NR tests are re-tested for their effects on cell growth. In this test, 96-well tissue culture plates are seeded with cells (sufficient to be approximately 20% confluent in the well) and exposed to varying concentrations of the test drug while the cells are dividing rapidly. The plates are then incubated in a CO₂ incubator at 37° C. for 72 hours, at which time neutral red is added and the degree of color intensity indicating viable cell number is determined spectrophotometrically; an IC₅₀ is determined by regression analysis.

Data Analysis:

Each test compound's anti-viral activity is expressed as a selectivity index (SI), which is the IC₅₀ or IC₉₀ divided by the EC₅₀. Generally, an SI of 10 or greater is indicative of positive anti-viral activity, although other factors, such as a low SI for the positive control, are also taken into consideration. Compounds having SI values of 10 or greater can be evaluated against additional strains of the original virus inhibited in order to more fully determine the spectrum of anti-viral activity of the compound.

6.6.4 General Procedures for Assays for Orthopoxviruses

To quickly screen out compounds that do not have activity against any of the herpes viruses, or are too toxic to evaluate, an assay such as a CPE-inhibition assay that is semi-automated is commonly used initially to screen out the negative compounds. Typically, all screening assays are conducted in low passage human cells, and each assay system contains a positive control (CDV) and a negative control (ACV). Efficacy is demonstrated by at least two different assay systems that detect functional biologic activity and should be confirmed using low passaged clinical isolates and drug resistant mutants whenever available. In the case of Vaccinia virus (VV) and Cowpox virus (CV), efficacy against VV and CV is confirmed using other isolates. Toxicity is determined using both resting and proliferating human fibroblast cells and proliferating lymphoblastic cells, and for selected compounds, toxicity in rodent myeloid and erythroid progenitor cells is assessed.

6.6.4.1 Screening Assays for VV and CV

Compounds are initially screened for activity using the CPE assay in HFF cells. Further testing in two other cells lines, Vero and MRC-5, and against other strains of virus is possible for compounds that demonstrate activity in other assay systems. The screening assay systems utilized are selected to show specific inhibition of a biologic function, i.e., cytopathic effect (CPE) in susceptible human cells. In the CPE-inhibition assay, test compound is added 1 hour prior to infection so the assay system will have maximum sensitivity and detect inhibitors of early replicative steps such as adsorption or penetration as well as later events. To rule out non-specific inhibition of virus binding to cells, all compounds that show reasonable activity in the CPE assay are confirmed using a classical plaque reduction assay in which the drug is added 1 hour after infection. These assay systems also can be manipulated by increasing the pre-treatment time in order to demonstrate anti-viral activity with oligodeoxynucleotides and/or peptides. By delaying the time of addition of compound after infection, information regarding which step in the virus life cycle is inhibited (i.e., early vs. late functions) can be gained. A direct inactivation assay can be employed to determine the virucidal activity of selected compounds.

Efficacy:

In the assays used for primary screening, a minimum of six compound concentrations is typically used, covering a range of, e.g., 100 mg/ml to 0.03 mg/ml, in 5-fold increments. These data allow for creating dose response curves. From these data, the dose that inhibited viral replication by 50% (effective concentration 50; EC₅₀) is usually calculated using a computer software program, for example, MacSynergy II by M. N. Prichard, K. R. Asaltine, and C. Shipman, Jr., University of Michigan, Ann Arbor, Mich.

Toxicity:

The same compound concentrations used to determine efficacy are also used on uninfected cells in each assay to determine toxicity of each experimental compound. The compound concentration that is cytotoxic to cells as determined by their failure to take up a vital stain, neutral red (cytotoxic concentration 50; CC₅₀), is determined as described above. A neutral red uptake assay can be used. The assay is reproducible and allows quantitation of toxicity based on the number of viable cells rather than cellular metabolic activity. In some cases, the toxicity of new compounds on dividing cells is determined at a very early stage of testing. A cell proliferation assay using HFF cells is a sensitive assay for detecting compound toxicity to dividing cells. The compound concentration that inhibits cell growth by 50% (IC₅₀) is calculated as described above. In comparison with four human diploid cell lines and Vero cells, HFF cells are known to be very sensitive and predictive of toxicity for bone marrow cells.

6.6.4.2 Confirmation Assays for VV and CV

Anti-viral Activity:

Compounds that show activity in the CPE-inhibition assay are confirmed using the plaque reduction assay. Susceptibility of additional virus strains of VV, CV and activity in other cell types can also be determined for selected compounds.

Toxicity:

In addition to the toxicity component incorporated into each assay system, a standardized cell cytotoxicity assay using a vital stain uptake (Neutral Red) is performed using 7 days of compound exposure to confluent non-dividing cells. This assay measures direct cell cytotoxicity (CC₅₀). In this regard, a neutral red uptake assay is reproducible and allows for quantitation of toxicity based on the number of viable cells rather than cellular metabolic activity. In some cases, the toxicity of new compounds on dividing cells is determined at a very early stage of testing. A cell proliferation assay using HFF cells is a sensitive assay for detecting compound toxicity to dividing cells, and the compound concentration that inhibits cell growth by 50% (IC₅₀) is calculated as described above.

6.6.5 In Vitro Laboratory Procedures for Assays for Orthopoxviruses

6.6.5.1 Efficacy Screening for VV and CV

Preparation of Human Foreskin Fibroblast (Hff) Cells:

Newborn Human foreskins are obtained as soon as possible after circumcision and placed in minimal essential medium (MEM) containing vancomycin, fungizone, penicillin, and gentamicin at the usual concentrations, for 4 hours. The medium is then removed, the foreskin minced into small pieces and washed repeatedly with phosphate buffered saline (PBS) deficient in calcium and magnesium (PD) until red cells are no longer present. The tissue is then trypsinized using trypsin at 0.25% with continuous stirring for 15 minutes at 37° C. in a CO₂ incubator. At the end of each 15-minute period, the tissue is allowed to settle to the bottom of the flask. The supernatant containing cells is poured through sterile cheesecloth into a flask containing MEM and 10% fetal bovine serum. The flask containing the medium is kept on ice throughout the trypsinizing procedure. After each addition of cells, the cheesecloth is washed with a small amount of MEM containing serum. Fresh trypsin is added each time to the foreskin pieces and the procedure repeated until all the tissue is digested. The cell-containing medium is then centrifuged at 1000 RPM at 4° C. for 10 minutes. The supernatant liquid is discarded and the cells are resuspended in a small amount of MEM with 10% FBS. The cells are then placed in an appropriate number of 25 cm² tissue culture flasks. As cells become confluent and need trypsinization, they are expanded into larger flasks. The cells are kept on vancomycin and fungizone to passage four, and maintained on penicillin and gentamicin. Typically, cells are used only through passage 10.

Cytopathic Effect Inhibition Assay:

Low passage HFF cells are seeded into 96 well tissue culture plates 24 hours prior to use at a cell concentration of 2.5×10⁵ cells per ml in 0.1 ml of MEM supplemented with 10% FBS. The cells are then incubated for 24 hours at 37° C. in a CO₂ incubator. After incubation, the medium is removed and 125 ml of experimental compound is added to the first row in triplicate wells, all other wells having 100 ml of MEM containing 2% FBS. The compound in the first row of wells is then diluted serially 1:5 throughout the remaining wells by transferring 25 ml using the BioMek 2000 Laboratory Automation Workstation. After dilution of the compound, 100 ml of the appropriate virus concentration is added to each well, excluding cell control wells, which received 100 ml of MEM. The virus concentration utilized is 1000 PFU's per well. The plates are then incubated at 37° C. in a CO₂ incubator for 7 days. After the incubation period, media is aspirated and the cells stained with a 0.1% crystal violet in 3% formalin solution for 4 hours. The stain is removed and the plates rinsed using tap water until all excess stain is removed. The plates are allowed to dry for 24 hours and then read on a BioTek Multiplate Autoreader at 620 nm. The EC₅₀ values are determined by comparing compound treated and untreated cells using a computer program.

Plaque Reduction Assay:

Two days prior to use, HFF cells are plated into 6 well plates and incubated at 37° C. with 5% CO₂ and 90% humidity. On the date of assay, the compound is made up at twice the desired concentration in 2×MEM and then serially diluted 1:5 in 2×MEM using 6 concentrations of compound. The initial starting concentration is usually 200 mg/ml down to 0.06 mg/ml. The virus to be used is diluted in MEM containing 10% FBS to a desired concentration which will give 20-30 plaques per well. The media is then aspirated from the wells, and 0.2 ml of virus is added to each well in duplicate with 0.2 ml of media being added to drug toxicity wells. The plates are then incubated for 1 hour with shaking every 15 minutes. After the incubation period, an equal amount of 1% agarose is added to an equal volume of each compound dilution. This addition gives final compound concentrations beginning with 100 mg/ml and ending with 0.03 mg/ml and a final agarose overlay concentration of 0.5%. The compound/agarose mixture is applied to each well in 2 ml volume and the plates are incubated for 3 days, after which the cells are stained with a 0.01% solution of neutral red in phosphate buffered saline. After a 5-6 hours incubation period, the stain is aspirated, and plaques counted using a stereomicroscope at 10× magnification.

6.6.5.2 Toxicity Screening for VV and CV

Neutral Red Uptake Assay:

Twenty-four hours prior to assay, HFF cells are plated into 96 well plates at a concentration of 2.5×10⁴ cells per well. After 24 hours, the media is aspirated and 125 ml of compound is added to the first row of wells and then diluted serially 1:5 using the BioMek 2000 Laboratory Automation Workstation in a manner similar to that used in the CPE assay. After compound addition, the plates are incubated for 7 days in a CO₂ incubator at 37° C. At this time, the media/compound mixture is aspirated and 200 ul/well of 0.01% neutral red in PBS is added. This mixture is incubated in the CO₂ incubator for 1 hour. The dye is aspirated and the cells are washed using a Nunc Plate Washer. After removing the PBS, 200 mg/well of 50% ETOH/1% glacial acetic acid (in H₂O) is added. The plates are rotated for 15 minutes and the optical densities read at 540 nm on a plate reader. The EC₅₀ values are determined by comparing compound treated and untreated cells using a computer program.

Cell Proliferation Assay:

Twenty-four hours prior to assay, HFF cells are seeded in 6-well plates at a concentration of 2.5×10⁴ cells per well in MEM containing 10% FBS. On the day of the assay, compounds are diluted serially in MEM containing 10% FBS at increments of 1:5 covering a range from 100 mg/ml to 0.03 mg/ml. For drugs that have to be solubilized in DMSO, control wells receive MEM containing 1% DMSO. The media from the wells is aspirated, and 2 ml of each drug concentration is then added to each well. The cells are incubated in a CO₂ incubator at 37° C. for 72 hours. At the end of this time, the media-compound solution is removed and the cells washed. One ml of 0.25% trypsin is added to each well and incubated until the cells start to come off of the plate. The cell-media mixture is then pipetted up and down vigorously to break up the cell suspension and 0.2 ml of the mixture is added to 9.8 ml of Isoton III and counted using a Coulter Counter. Each sample is counted 3 times with 2 replicate wells per sample.

Bone Marrow Clonogenic Assay:

In vitro toxicity to bone marrow progenitor cells can be determined by inhibition of myeloid [colony-forming units granulocyte/macrophage (CFU-GM)] and erythroid [burst-forming unit-erythroid (BFU-E)] colony formation in soft agar clonal assays. Using a 21-23 gauge needle attached to a syringe, rodent bone marrow cells are collected from the leg bone of rats or mice by flushing with Isocoves' Modified Dulbecco's medium (IMDM). A single cell suspension is obtained by repeated aspiration through the needle. Nucleated cells are enumerated with a hemacytometer and adjusted to the desired cell concentration in IMDM. Murine CFU-GM assays are prepared with 2.5×10⁵ nucleated cells/ml, 20% FBS, 10 ng/ml rmGM-CSF, and 0.2% agarose. BFU-E cultures include 30% FBS, 1% deionized BSA, 0.1 mM 2-ME, 4 U/ml rhEpo, 10 ng/ml rmIL-3, 2.5×10⁵ nucleated cells/ml and 0.2% agarose. Triplicate wells (in 6 well plates) containing 0.1 ml of compound (10×) receive 1 ml of either culture mixture for each concentration group and slowly mixed. The cultures are allowed to gel at 4° C. and then incubated for 7 (CFU-GM) or 9 (BFU-E) days at 37° C. in a humidified atmosphere of 5% CO₂ in air. Colonies are counted using an inverted microscope. CFU-GM colonies are identified as cell clones containing at least 40 cells. BFU-E cultures are stained with dianisidine, and aggregates of greater than 60 hemoglobin-containing cells are counted as erythroid colonies. The median inhibitory concentration (IC₅₀) and the 90% inhibitory concentration (IC₉₀) are derived from linear regression analysis of the logarithm of compound concentration versus CFU-GM or BFU-E survival fraction.

6.6.6 Assays for Hepatitis Viruses

6.6.6.1 Hepatitis B Virus (HBV)

A variety of cell-culture based anti-HBV analyses are available. Candidate compounds are initially assayed in a primary screening assay. Compounds demonstrating reasonable anti-viral and cytotoxicity profiles are then candidates for several additional follow-up analyses. For the primary screening assay, routinely 2-3 mg are required for compounds with molecular weights in the range of standard nucleosides (e.g., 300-500). Additional compound may be required for follow-up analyses. Molecular weights and solubility information are provided if available. If no preferred solvent is specified, 100% tissue culture DMSO will be used. Compounds are typically solubilized in aqueous solutions (normal pH range) at a minimum of a 10× final testing concentration or in DMSO at a minimum 50× test concentration. EtOH is generally not well tolerated by the cell lines used for these studies, but final concentrations of EtOH of less than 0.03% are usually acceptable. Compounds which need to be tested in other solvents should be accompanied by a small amount of solvent (under a separate accession number) to control for cytotoxicity. For compounds in solution, approximately 0.25 ml of a 100× stock is minimally required.

Primary Assay:

HBV anti-viral assays (Korba & Gerin, Antivir. Res. 1992, 19:55) are conducted using confluent cultures of 2.2.15 cells maintained on 96-well flat-bottomed tissue culture plates (confluence in this culture system is required for active, high levels of HBV replication equivalent to that observed in chronically-infected individuals (Sells et al., J. Virol. 1988, 62:2836; Korba and Gerin, Antivir. Res. 1992, 19:55). HepG2-2.2.15 is a stable cell line containing the hepatitis B virus (HBV) ayw strain genome. Anti-viral compounds blocking any late step of viral replication such as transcription, translation, pregenome encapsidation, reverse transcription, particle assembly and release can be identified and characterized using this cell line.

Cultures are treated with nine consecutive daily aliquots of the test compounds. Typically, 4 doses (10-fold or 3-fold steps), in triplicate are used. HBV DNA levels in the culture medium (representing HBV virion production) are assessed by quantitative blot hybridization 24 hours after the last treatment. Alternatively, whether a compound reduces the production of secreted HBV from cells can be initially assessed utilizing real time quantitative PCR (TaqMan) assay to directly and accurately measure HBV DNA copies. Cytotoxicity is assessed by uptake of neutral red dye 24 hours following the last treatment. Lamivudine (LMV) is used as the standard assay control, but other control compounds are also available.

EC₅₀, EC₉₀ and CC₅₀ values are calculated by linear regression analysis (MS EXCEL®, QuattroPro®) using data combined from all treated cultures (Korba & Gerin, Antivir. Res. 1992, 19:55; Okuse et al., Antivir. Res. 2005, 65:23). Standard deviations for EC₅₀ and EC₉₀ values are calculated from the standard errors generated by the regression analyses. EC₅₀ and EC₉₀ are compound concentrations at which a 2-fold, or a 10-fold depression of HBV DNA (relative to the average levels in untreated cultures), respectively, is observed. CC₅₀ is the compound concentration at which a 2-fold lower level of neutral red dye uptake (relative to the average levels in untreated cultures) is observed. The Selectivity index (S.I.) is calculated as CC₅₀/EC₉₀ since at least a 3-fold depression of HBV DNA levels is typically required to achieve statistical significance in this assay system (Korba & Gerin, Antivir. Res. 1992, 19:55).

Secondary Assay:

Confluent cultures of 2.2.15 cells maintained on 48-well flat-bottomed tissue culture plates are treated as described for the primary assay. HBV virion DNA levels in the culture medium and cytotoxicity are assessed as described for the primary assay. In addition, intracellular HBV DNA replication is measured by quantitative Southern blot hybridization analysis (Korba & Gerin, Antivir. Res. 1992, 19:55). EC₅₀, EC₉₀ and S.I. values are calculated for both virion DNA and intracellular HBV DNA replication intermediates. In certain cases, additional assays (tertiary assays) can be conducted.

Combination Studies:

Compounds are mixed at approximately equipotent concentrations and this molar ratio is maintained during serial dilution (Korba, Antivir. Res. 1996, 29:49; Iyer et al. 2004). To compensate for potential unforeseen interactions (e.g., changes in uptake, metabolism, etc.), the concentration of one compound is altered approximately 3-fold higher of lower relative to the second compound so that three different ratios are used in one experiment. Cultures are treated with 6-8 serial dilutions of the mixtures, as with the corresponding monotherapies, as described for the primary assay. Evaluation of compound interactions in the combination treatments is conducted against the corresponding monotherapies in the same experiments using the Combostat® (Biosoft, Inc.) analysis software. For combination treatments, EC₅₀, EC₉₀, CC₅₀ and S.I. (CC₅₀/EC₉₀) are presented for the first compound listed. The molar ratio of the compounds in each combination is also indicated.

Alternatively, after the anti-viral activity of test compounds against HBV is confirmed, the interactions of the compounds with 3TC, IFNα and other compounds in terms of efficacy (synergy, additivity, antagonism) and toxicity (combination toxicity) can be evaluated with the 2.2.15 cells using the quantitative HBV TaqMan PCR assay.

Drug Resistant HBV:

Activity against recombinant HBV carrying clinically relevant mutations that confer resistance to licensed drugs is performed using transient transfection of HBV DNA (Tatti et al., Antivi. Res. 2002, 55:27; Iyer et al., AAC 2004, 48:2199). Cultures are transfected in 48-well culture plates with Lipofectamine 2000™ (Gibco, Inc) following the manufacturer's procedure. Beginning three days post-transfection, cultures are treated for 5 days with anti-viral compounds. Anti-viral activity is determined by quantitative Southern Blot hybridization of intracellular HBV DNA replication intermediates. Currently, the following mutants are available: lamviudine (LMV)-resistant, polM204V, polM2041, polL180M, polM204V/L180M (Allen et al., Hepatology 1998, 27:1670); adefovir dipovoxil (ADV)-resistant, polN236T (Angus et al., Gastroenterology 2003, 125:292). Standardized nomenclature is used for HBV polymerase assignment (Stuyver et al., Hepatology 2001, 33:751). Additional mutants (TNFR, ETVR) are under construction.

Other tests can be conducted in order to evaluate the ability of compounds to inhibit the known 3TC- and penciclovir-resistant mutants of HBV. Stable cell lines with control wild-type HBV and the following mutations known to be associated with resistance of HBV to these agents can be used: (1) L526M (rtL180M) of Domain B & YMDD M550V (rtM204V) of Domain C (the most common mutation pattern observed during HBV breakthrough viremia); (2) L526M alone (the most common mutation associated with penciclovir resistance; also associated with some resistance against 3TC); and control wild-type HBV.

HBV Protein Production and RNA Transcription:

Semi-quantitative ELISA-based analysis of HBV proteins is performed (Korba & Gerin, Antivir. Res. 1995, 28:225; Korba et al., Antivir. Res. 2008, 77:56) using samples diluted (2 to 10-fold) to bring levels into the dynamic response ranges of the assays. Qualitative analysis of HBV proteins is also performed using standard Western blot techniques (Muller et al., J. Infect. Dis. 1992, 165:929). HBV surface (HBsAg) and HBV e (HBeAg) antigens are analyzed from culture medium samples, and HBV core (HBcAg) is analyzed from intracellular lysates (normalized for total cell protein content in each culture sample). Intracellular HBV RNA (normalized to the level of cellular B-actin RNA in each culture sample) is assessed by quantitative northern blot hybridization (Korba & Gerin, Antivir. Res. 1995, 28:225).

HBV Mechanism of Action Studies:

A variety of assays can be used to pinpoint the mechanism of action of anti-viral compounds. Examples include the following:

-   -   Extracellular HBV virions: In addition to the quantitative PCR         analysis, a Southern blot of the HBV particles secreted from         compound-treated cells can be performed;     -   Intracellular HBV particles: HBV particles can be isolated from         the treated 2.2.15 cells and the pregenomic RNA examined by         Southern blot analysis. This can be helpful in identifying the         site of action of a late-acting compound;     -   Intracellular HBV replicative intermediates: Nucleic acids         isolated from the cells can be examined by Southern blots to         assess the distribution of circular partially double-stranded         HBV DNA, linear partially double-stranded DNA and single         stranded HBV DNA;     -   HBV transcription: Effects on HBV genomic and subgenomic viral         RNA synthesis are studied by Northern blot and primer extension         analysis;     -   HBsAg and HBeAg release assay: ELISAs are used to quantify the         amounts of the HBV envelope protein, surface antigen (HBsAg),         and of secreted e-antigen (HBeAg) released from cultures;     -   Western blot analysis: Western blots are conducted to study HBV         core and envelope protein expression;     -   Novel mechanism of action studies: Specific effects on HBV         transcription and replication may arise from alterations in         DNA-protein interactions, sometimes affected by cellular growth         factors, at the HBV enhancers, promoters or through the         transcriptional transactivator X-protein; and     -   Endogenous Polymerase Assay: Extracellular HBV virions contain         partially double-stranded circular DNA genomes. Purified virions         are used to assay the ability of anti-viral drugs to inhibit the         endogenous polymerase activity of HBV. Normally, this activity         functions to complete (+) strand synthesis following the         infection of new cells by HBV virions.

6.6.6.2 Hepatitis C Virus (HCV) Protocol I

Cell line Huh7 ET (luc-ubi-neo/ET), which contains a new HCV RNA replicon with a stable luciferase (LUC) reporter, is used. It is similar to the cell line 5-2 (Krieger et al., J. Virol. 2001, 75:4614-4624.), but contains additional modifications that make the cell line more robust and provide stable LUC expression for anti-viral screening. The composition of the replicon is shown diagrammatically below:

The HCV RNA replicon ET contains the 5′ NTR (IRES) of HCV 5′ which drives the production of a firefly luciferase (Luc), ubiquitin (Ubiq), and neomycin phosphotransferase (Neo) fusion protein. Ubiquitin cleavage releases the LUC and Neo genes. The EMCV IRES element (E-I) controls the translation of the HCV structural proteins NS3-NS5. The NS3 protein cleaves the HCV polyprotein to release the mature NS3, NS4A, NS4B, NS5A and NS5B proteins that are required for HCV replication. At the 3′ end of the replicon is the authentic 3′ NTR of HCV.

The LUC reporter is used as an indirect measure of HCV replication. The activity of the LUC reporter is directly proportional to HCV RNA levels and positive control anti-viral compounds behave comparably using either LUC or RNA endpoints. The use of the LUC endpoint is more economical than HCV RNA and can be used for high-throughput applications to screen libraries of compounds.

Primary HCV RNA Replicon Assay:

First, the effect of compounds added in triplicate at a single high-test concentration of 20 mM on HCV RNA-derived LUC activity and cytotoxicity is examined. Human interferon alpha-2b is included in each run as a positive control compound. Subconfluent cultures of the ET line are plated out into 96-well plates that are dedicated for the analysis of cell numbers (cytotoxicity) or anti-viral activity, and test compounds are added to the appropriate wells the next day. Cells are processed 72 hours later when the cells are still subconfluent. Compounds that reduced the LUC signal by 50% or more relative to the untreated cell controls move forward to the next screening steps. A compound's cytotoxicity is assessed as the percent viable cells relative to the untreated cell controls.

HCV RNA Replicon Confirmation Assay:

The HCV RNA replicon confirmatory assay is then used to examine the effects of compounds at, for example, five half-log concentrations each. Human interferon alpha-2b is included in each run as a positive control compound. Subconfluent cultures of the ET line are plated out into 96-well plates that are dedicated for the analysis of cell numbers (cytotoxicity) or anti-viral activity and the next day test compounds are added to the appropriate wells. Cells are processed 72 hours later when the cells are still subconfluent. Compound EC₅₀ and EC₉₀ values (anti-viral activity) are derived from HCV RNA levels assessed as either HCV RNA replicon-derived LUC activity or as HCV RNA using TaqMan RT-PCR. Compound IC₅₀ and IC₉₀ values (cytotoxicity) are calculated using CytoTox-1 (Promega), a colorimetric assay used as an indicator of cell numbers and cytotoxicity when the LUC assay system is employed, while ribosomal (rRNA) levels determined via TaqMan RT-PCR are used as an indication of cell numbers in the RNA-based assay. Compound selectivity indices SI₅₀ and SI₉₀ values are also calculated.

6.6.6.3 Hepatitis C Virus (HCV) Protocol II

A variety of cell-culture based anti-HCV analyses are available. Candidate compounds are initially assayed in a primary screening assay. Compounds demonstrating reasonable anti-viral and cytotoxicity profiles are then candidates for several additional follow-up analyses. For the primary screening assay, routinely 2-3 mg are required for compounds with molecular weights in the range of standard nucleosides (e.g., 300-500). Additional compound may be required for follow-up analyses. Molecular weights and solubility information are provided if available. If no preferred solvent is specified, 100% tissue culture DMSO is used. Compounds are solubilized in aqueous solutions (normal pH range) at a minimum of a 10× final testing concentration or in DMSO at a minimum 50× test concentration. EtOH is generally not well tolerated by the cell lines used for these studies, but final concentrations of EtOH of less than 0.03% are acceptable. Compounds which need to be tested in other solvents should be accompanied by a small amount of solvent (under a separate accession number) to control for cytotoxicity. For compounds in solution, approximately 0.25 ml of a 100× stock is minimally required.

Primary Assay:

Anti-viral activity against HCV is assessed in a 3-day assay (Okuse et al., Antivir. Res. 2005, 65:23; Korba et al., Antivir. Res. 2008, 77:56) using the stably-expressing HCV replicon cell line, AVA5 (sub-genomic (CON1), genotype 1b) (Blight et al., Science 2000, 290:1972) maintained as sub-confluent cultures on 96-well plates. Anti-viral activity is determined by blot hybridization analysis of intracellular HCV RNA (normalized to the level of cellular B-actin RNA in each culture sample). Cytotoxicity is assessed by neutral red dye uptake in cultures maintained in parallel plates.

EC₅₀, EC₉₀ and CC₅₀ values are calculated by linear regression analysis (MS EXCEL®, QuattroPro®) using data combined from all treated cultures (Korba & Gerin, Antivir. Res. 1992, 19:55; Okuse et al., Antivir. Res. 2005, 65:23). Standard deviations for EC₅₀ and EC₉₀ values are calculated from the standard errors generated by the regression analyses. EC₅₀ and EC₉₀ are compound concentrations at which a 2-fold, or a 10-fold depression of intracellular HCV RNA (relative to the average levels in untreated cultures), respectively, is observed. CC₅₀ is the compound concentration at which a 2-fold lower level of neutral red dye uptake (relative to the average levels in untreated cultures) is observed. The Selectivity index (S.I.) is calculated as CC₅₀/EC₉₀. Recombinant human interferon 2b (PBL laboratories, Inc.) is used as an assay control. Compounds currently in clinical trials that are directed against NS3 and NS5B can also be used.

Secondary Assay:

This assay assesses activity against additional genotypes using the format described for the primary assay. Activity against the genotype 1b HCV is included for comparison. One exemplary replicon cell line contains H/FL-Neo (genotype 1a (H77), full length construct) (Blight et al., J. Virol. 2003, 77:3181). A genotype 2a construct (J6/JFH-1, full length) can be used to assess for future inclusion. EC₅₀, EC₉₀, CC₅₀ and S.I. values are calculated for each replicon cell line. In some instances, additional assays (tertiary assays) may also be conducted.

Combination Studies: Compounds are mixed at approximately equipotent concentrations and this molar ratio is maintained during serial dilution (Korba, Antivir. Res. 1996, 29:49; Iyer et al., 2004). Usually, three different ratios are used in one experiment. Cultures are treated with 6-8 serial dilutions of the mixtures, as with the corresponding monotherapies, as described for the primary assay. Evaluation of compound interactions in the combination treatments is conducted against the corresponding monotherapies in the same experiments using the Combostat® (Biosoft, Inc.) analysis software. For combination treatments, EC₅₀, EC₉₀, CC₅₀ and S.I. (CC₅₀/EC₉₀) are presented for the first compound listed. The molar ratio of the compounds in each combination is also indicated.

Drug-Resistant HCV:

Since no licensed anti-HCV drugs for which resistance mutations have yet been identified, a panel of mutants conferring resistance to compounds in mid to late phase clinical trials is compiled. Some available stable replicon-containing cell lines (Korba et al., Antivir. Res. 2008, 77:56) are genotype 1 B NS5B S282T (Perra et al., Nucleosides Nucleotides Nucleic Acids 2005, 24:767), and NS3 A156S and NS3 A156V (Courcambeck et al., Antivir. Ther. 2006, 11:847) drug-resistant mutants. The genetic background is the same as that in the BB7 replicon (AVA5 cells) used in the primary assay. Activity against these mutants is assessed as described in the primary assay, except that semi-quantitative real-time PCR is used for the analysis of HCV RNA due to reduced replication levels.

The genotype 1b mutants can also be assessed in this manner. For this assay, Huh7.5 cells are transfected with HCV RNA using Liofectamine 2000™ (Gibco, Inc.) in 6-well culture plates. Three days post-transfection, cultures are exposed to 125 μg/mL G418 and test compounds. After 10-14 days, surviving colonies are fixed, stained, and counted. EC₅₀ and EC₉₀ values are calculated for each transfected RNA.

6.6.7 Assays for Papilloma Viruses

Assays for Human Papilloma Virus (HPV) 11 and 40:

A431 cells are plated 2×10⁵ cells/well in 6-well cluster dishes. Replicate aliquots of HPV-11 (or HPV-40) are added to each well representing an MOI of 150 particles per cell. Dilutions of compound are added to triplicate cultures. Control wells without virus are included and receive media alone. Positive control compound can be, e.g., HPMPC (cidofovir) at 300 μg/ml. Cell cultures are harvested, lysed with Trizol reagent (GIBCO/BRL) and RNA prepared. QRT-PCR is conducted to quantitate the proportion of viral E1-E4 transcripts and a cellular reference RNA for the TATA-binding protein (TBP). Anti-viral effects of compounds are assessed as an EC₅₀ value representing a 50% reduction in the amount of E1-E4 viral transcript when compared with cultures infected with HPV-11 (or HPV-40) alone. CC₅₀ toxicity is calculated as the compound dose at which 50% of total cellular RNA is recovered. From these two values, the Selectivity Index (SI) is determined from CC₅₀/EC₅₀. Usually, SI>5 would be significant for the detection of an anti-viral activity.

The assay procedure can be modified to test compounds with microbicidal activity if necessary. This modification is represented by drug addition to A431 cells at the same time as infectious virus.

Assays for Bovine Papilloma Virus (BPV) 1:

C127 cells are plated 3×10³ cells/well into wells of a 96-well flat-bottomed microculture plate. Replicate aliquots of BPV-1 are added to each well, representing approximately 100 focus-forming units. Control wells without virus are included. Dilutions of drug are added to triplicate cultures of both BPV-1-infected and uninfected cultures. Control wells receive media without compound. Positive control compound can be, e.g., cidofovir at 5 μg/ml. Cell cultures are fed with medium and compound every 3-4 days. Cell numbers and viability are assessed using the MTS assay. Anti-viral effects of compounds are calculated using the following formula to obtain % anti-viral activity: B&A/B&C×100%=% Anti-viral activity

-   -   A=O.D. of BPV-1-containing, compound-treated cultures     -   B=O.D. of BPV-1 containing cell cultures     -   C=O.D. of cultures of cells alone.         The EC₅₀ value represents a 50% reduction in the amount of O.D.         values (MTS signal) of compound-treated virus-infected cultures         when compared with cultures containing BPV-1 alone and cultures         containing cells alone. The Selectivity Index (SI) is determined         from CC₅₀/EC₅₀. Usually, SI>5 would be significant for the         detection of an anti-viral activity.

The assay procedure can be modified to test compounds with microbicidal activity if necessary. This modification is represented by drug addition to C127 cells at the same time as infectious virus.

Assays for Human Papilloma Virus (HPV) 31b:

Cultures of CIN612, clone 9E cells are prepared from known protocols. Individual rafts are developed containing multi-layers of 9E cells growing on a collagen matrix impregnated with mitomycin C-treated fibroblast cells. Rafts are treated with compound delivered into the cell culture media that can diffuse into the 9E multilayer. Treatments are continuous for the culture duration, which is typically a period of 10 days. After 10 days culture, the 9E rafts are harvested and assayed for HPV-31b DNA (measure of viral DNA replication) and E1-E4 viral transcription (viral function) using the QRT-PCR assay described for the HPV-11 monolayer assay system. Primers are prepared to quantitate HPV-31B DNA and RNA (E1-E4) and the quantitation compared to TBP. Anti-viral activity is measured quantitatively as either or both a reduction in viral DNA and RNA when compared to placebo-treated 9E rafts. A portion of each raft is removed for histology (H&E, immunostaining for specific marker keratins [keratin 10, involucrin]). Viral DNA and RNA levels are plotted against compound concentrations to determine EC₅₀ (50% reduction in viral DNA and/or RNA), CC₅₀ (50% reduction in yield of total RNA/DNA). The Selectivity Index (SI) is determined from CC₅₀/EC₅₀. Usually, SI>5 would be significant for the detection of an anti-viral activity.

6.6.8 Assays for BK Virus (BKV)

Assays for BK virus (BKV) can be conducted by following the procedures described in, e.g., Farasati et al., Transplantation, 2005, 79(1):116-118. Generally, the principle of the assay is to measure the effect of test compounds on the rate of viral replication by quantitative real-time PCR for BKV viral capsid protein 1 DNA. Simultaneous quantification of a housekeeping gene such as aspartoacylase (ACY) DNA permits monitoring of host-cell replication. Regression analysis of dose-response curve allows for determination of EC₅₀, which is defined as the compound concentration that reduces the yield of BKV DNA by 50%. The ratio of IC₅₀ to EC₅₀ (selectivity index) is used to compare the anti-viral effect of different test compounds in relation to their safety.

For example, anti-viral testing can be performed using BKV, Gardner strain (available from ATCC). The cells are expanded, e.g., in human embryonic lung fibroblasts (WI-38 cells), using DMEM medium supplemented by 10% fetal bovine serum and L-glutamine, incubated at 37° C. under 5% CO₂. Each test compound is typically tested at least three times using a broad range of concentrations covering 4-5 orders of magnitude. Experiments usually include a negative control consisting of cells exposed only to the diluents.

Each compound sensitivity experiment requires inoculation of 50,000 log-phase WI-38 cells in six-well culture plates. After plating the cells, viral infection is achieved by the addition of 2×10³ to 2×10⁶ BKV particles to each culture well in a volume of 0.5 mL. After a 2 hours of 37° C. incubation, unbound virus is washed off with tissue culture medium. The cultures are maintained in DMEM medium, supplemented by 10% fetal bovine serum and L-Glutamine, at 37° C., under 5% CO₂, for 7 days. Cells are harvested by 0.25% trypsin-1 mM Na-EDTA digestion at 37° C. for 10 minutes and viability assessed by Trypan blue dye exclusion test. DNA extraction on the cell lysates is performed with a commercially available kit (QIAamp DNA Mini kit, Qiagen, Valencia, Calif.). BKV VP-1 DNA is amplified from the total DNA by a TaqMan quantitative PCR reaction performed in an ABI Prism 7700 Sequence Detector (ABI, Foster City, Calif.). To keep track of variable input of cellular DNA in different cell-culture experiments, each cell lysate is subjected to simultaneous TaqMan PCR for ACY.

6.6.9 Assays for Dengue Virus (DENV)

In vitro assays for DENV can be conducted using procedures substantially similar to those described, for example, in Heaton et al., Proc. Natl. Acad. Sci., 2010, 107(40): 17345-17350. Huh-7.5 cells (a subline derived from the hepatocyte Huh7 cell line) are maintained in DMEM-high glucose supplemented with 0.1 mM nonessential aminid acids, 5% v/v FBS, and penicillin-streptomycin. In certain cases, DENV-luciferase replicon RNAs are introduced in Huh-7.5 cells by electroporation. At 24 hour post-electroporation, the cells are treated with varying concentrations of test compounds, maintained for another 24 hours, and assayed for luciferase activity.

In other cases, Huh-7.5 cells are infected with DENV (multiplicity of infection=1) for 4 hours and then treated with test compounds at varying concentrations. Twenty four hours post-infection, viral RNA levels or released virus are quantified along with cellular ATP levels.

Three types of in vitro assays for DENV include those described in Chen et al., Antimicrobial Agents and Chemotherapy, 2010, 54(8):3255-3261.

Type 1:

The assays measure viral titer reduction in the presence of test compounds. Vero cells are seeded in a 12-well plate (4×10⁵ cells per well). At 24 hours post-seeding, the cells are infected with DENV at a multiplicity of infection of 0.1 and treated immediately with the test compounds. Culture medium are collected at an appropriate time, and viral titers are determined using plaque assays.

Type 2:

Cell-based flavivirus immunodetection (CFI) is used to measure the amount of viral E protein in infected cells. A549 cells are seeded to a 96-well plate (2×10⁴ cells per well). The cells are infected with DENV on the following day. During the infection, the cells are incubated with a test compound/virus mixture for 1 hour, with shaking every 10 to 15 minutes. The culture fluid is then replenished with fresh medium containing test compounds. On day 2 post-infection, the cells are washed with PBS, fixed with 100% methanol at 4° C. for 10 minutes, and detected for intracellular viral E protein by ELISA. The ELISA uses mouse monoclonal antibody 4G2 against the DENV E protein and goat anti-mouse IgG conjugated with hoseradish peroxidase as the primary and secondary antibodies, respectively.

Type 3:

The assay uses Huh-7 cells and luciferase-reporting replicon of DENV. The procedures are similar to those described above.

6.7 In Vivo Assays

6.7.1 In Vivo Assays for Herpes Viruses

6.7.1.1 HSV-1 and HSV-2

Animal Models of Herpes Encephalitis:

Virus Species Route Disease HSV-1 BALB/c Mice i.p. Encephalitis i.n. Encephalitis HSV-2 BALB/c Mice i.p. Encephalitis i.n. Disseminated infection of newborns and encephalitis HSV-1 Rat i.n. Encephalitis HSV-1 SKH-1 Mice i.cut. Herpes labialis

New compounds are screened initially for HSV activity in BALB/c mice (Charles River Laboratories) inoculated i.p. with HSV-1 or HSV-2. Following i.p. inoculation with HSV-1 or HSV-2, virus replicates in the gut, liver, and spleen and spreads to the CNS by viremia and likely peripheral nerves as well. Virus is detected first in the brain around day five, thus allowing time for compounds to demonstrate anti-viral effects. This model system one of the most sensitive for determining efficacy of a new anti-viral compound. Although it does not simulate a natural route of infection, it allows for screening new compounds to determine optimal dosages and treatment regimens. This screening is followed by testing in mice inoculated i.n. which more closely simulates human infections. If the experimental compound exhibits activity in mice inoculated i.p., it is next evaluated in mice inoculated by the i.n. route.

I.n. inoculation of three-week-old BALB/c mice with HSV-1 provides a model for herpes encephalitis of humans utilizing a natural route of infection. After inoculation of approximately 105 pfu of HSV-1, strain E-377, virus replicates in the nasopharynx and spreads to the CNS by way of olfactory and trigeminal nerves. Untreated animals generally die by days 6-10. The use of i.n. inoculation is known as a natural route of infection for herpes encephalitis. I.n. inoculation of three-week-old BALB/c mice with about 4×10⁴ pfu of HSV-2, strain MS, provides a model of disseminated neonatal herpes with CNS involvement. After viral inoculation, virus replicates in nasopharyngeal and lung tissue, and disseminates to the liver, spleen, and kidney. In addition, virus spreads to the CNS via olfactory and trigeminal nerves. Acyclovir, ACV, given parenterally or orally is effective in all the experimental infections mentioned above and is utilized as a positive control.

The SKH-1 strain of immunocompetent hairless mice is used to facilitate scoring of cutaneous lesions. Orofacial inoculation of HSV-1 in these mice provides an appropriate model for testing new anti-viral therapies. In this model, mice are anesthetized with a ketamine/xylazine mixture and injected subcutaneously with an electronic microchip for individual identification. Prior to inoculation, the snout, composed of the triangular shaped area over the nasal bones from the nose bridge to the eyes, is lightly abraded with a #113 tungsten-carbide engraving bit Dremmel tool. This procedure is performed carefully to prevent bleeding. This area is then swabbed for 10 seconds with a dacron swab soaked with HSV-1. Following this procedure, animals are returned to their cages and observed until recovery.

Animals infected with HSV-1 in the orofacial area exhibit lesions that begin to appear on days 4-6 and are usually cleared by day 15. To determine the effect of treatment on cutaneous viral replication, severity of lesions is scored from days 4-21 and swabs of the snout area are taken on days 3-10. The samples are placed in 2.0 mls of media and frozen at −70° C. until titrated for HSV-1 on rabbit kidney fibroblast cells in a CPE microtiter plate assay. All experimental drug efficacy studies are placebo or vehicle controlled and also the positive control, Zovirax, is administered topically.

Mouse Model of Primary HSV-1/HSV-2 Challenge:

The primary screening model provides a rapid initial evaluation of anti-viral efficacy against HSV primary infection with both clinical and virological endpoints. This model utilizes intravaginal inoculation of female Swiss Webster mice (25 g) with HSV-1 or HSV-2 to evaluate potential anti-viral therapies as well as vaccine/adjuvant candidates. Animals are followed daily for signs and systems of herpes disease and vaginal swabs are obtained to evaluate the effect of therapy on viral replication. Single or combined anti-viral therapies can be administered topically, orally or systemically and can be given at varying intervals begun before or after viral challenge. Dose range studies can also be performed. Dose and route of administration are individualized for each experimental compound. Treatment group size is typically 12-16 mice.

Microbicide Screening Model of Primary HSV-2 Challenge in Mice:

This model is designed to evaluate the protection afforded by a microbicide candidate against infection with HSV-2. The model utilizes intravaginal inoculation of female Swiss Webster mice for evaluation. The initial trial is usually performed by applying compound 5 minutes prior to challenge with HSV-2. Further evaluation of microbicides in this model either extend the time between microbicide administration and challenge or examine dose range. Compounds can be advanced to a secondary species evaluation in the guinea pig model of genital infection. Evaluation includes daily evaluation for signs and symptoms of genital herpes and viral examination of vaginal secretions. Treatment group size is typically 12-16 mice.

Guinea Pig Model of Primary Genital HSV-2 Infection:

Because genital herpes disease in the guinea pig more closely resembles human disease, this animal is used as a second species for therapies with demonstrated efficacy against HSV in mice. As with humans, genital HSV infection in guinea pigs is a self limited vesiculoulcerative disease which is followed by healing, the establishment of latency, and then both spontaneous and inducible symptomatic and asymptomatic recurrences. An exemplary model utilizes intravaginal inoculation of female Hartley guinea pigs and provides both clinical and virologic indices to asses both the effect of treatment on primary disease as well as on the frequency or severity of subsequent recurrent infections. Anti-viral therapy can be administered orally, topically or systemically and can be given at varying intervals beginning before or after virus challenge. Following intravaginal inoculation, animals are followed daily for the development of genital herpes using a validated genital herpes scoring system. Vaginal swabs are also obtained to evaluate the effect against viral replication. Because this is a non lethal model, animals can be sacrificed at the conclusion of the experiment to evaluate the effects of treatment on latency. This model can be adapted to evaluate anti-viral activity against available drug resistant strains (ACV and Foscarnet). Dose, route of administration and duration of treatment are individualized for each experimental agent. Treatment group size is typically 10-15 animals.

Guinea Pig Model of Recurrent Genital HSV-2 Infection:

The guinea pig model of genital herpes is unique in that after recovery from primary genital infection, animals experience spontaneous recurrent genital lesions as well as viral shedding in the absence of lesions. This allows a candidate compound to be evaluated for efficacy in controlling recurrent disease. Female Hartley guinea pigs who have recovered from symptomatic primary genital infection are randomized into treatment groups for anti-viral treatments beginning on day 21 PI and continued for 21 days after. Treatments can be given orally, topically or systemically. The indices for these studies include quantification and severity assessment of recurrent episodes during treatment and for 21 days following cessation of treatment. Additionally, vaginal swabs are collected to evaluate any impact on shedding. Dose, route of administration are individualized for each experimental agent. Treatment group size is typically 10-15 animals, and duration of treatment is typically 21 days.

Model of Neonatal HSV-2 Infection in Guinea Pigs:

An exemplary model of neonatal HSV infection mimics the natural history of infection in the human newborn. This model is available to evaluate candidate anti-viral compounds and combined therapeutic approaches including combination of anti-virals or anti-virals and immune modulators. Additionally, this model can be used to evaluate the efficacy of candidate vaccines by measuring the protection afforded by transplacental antibody. In this model, newborn Hartley guinea pigs are inoculated intranasally with HSV-2 within 48 hours of delivery. Newborn animals are then randomized to receive experimental compound, placebo or ACV (control). A positive control of ACV (60 mg/kg/day) BID is typically used. Animals are evaluated daily for evidence of cutaneous herpetic disease and weight gain as well as pulmonary, CNS symptoms and death. Surviving animal are followed for 45 days to assess the effectiveness of therapy on the incidence and frequency of cutaneous herpetic recurrences. Dose and route of administration are individualized for each experimental agent. Duration of treatment is typically 10 days or more.

6.7.1.2 Cytomegaloviruses

Animal Models for Cytomegalovirus Infections:

Virus Species Route Disease MCMV BALB/c mice i.p. Disseminated CMV acute, chronic SCID-mice i.p. Disseminated CMV acute HCMV SCID-hu-Ret i.oc. HCMV replication in Retinal tissue SCID-hu-thy/liv i.im. HCMV replication in thymus/liver tissue

Human CMV does not generally infect laboratory animals. For this reason, it is necessary to use surrogate models, that is, a similar but different virus in its natural host. While there are cytomegalovirus strains in a number of animal species, two that have been studied include the murine and guinea pig CMVs. The murine model is predictive of efficacy for anti-viral drugs, such as Foscarnet (PFA), ganciclovir (GCV), and cidofovir (CDV) that have been evaluated in humans.

I.p. inoculation of three-week-old BALB/c mice with approximately 2.0×10⁵ pfu of MCMV results in an acute, lethal infection with rapid virus replication in the lung, liver, spleen, kidney, intestine, salivary gland, and other visceral and glandular tissue. Animals die on approximately days 5-7. Since this is a lethal infection, the model can be used for rapid identification of potential anti-viral compounds. Reduction of the virus inoculum to 10⁴ pfu of MCMV results in a non-lethal, chronic, generalized infection, which has many similarities to human CMV infections. At various times after inoculation, virus can be readily isolated from blood, lung, liver, spleen, kidney, urine, intestine, and salivary gland. Virus replication persists in these target organs for 45-60 days and in the salivary gland for months. The nature of the chronic infection allows for evaluating long term or maintenance therapy.

Severe combined immunodeficient (SCID) mice, which lack functional T and B cells, are extremely sensitive to infection with MCMV and are utilized as models for CMV infections in an immunocompromised host. SCID mice that are inoculated with a range of 1.0-10⁵ pfu of MCMV, and are left untreated, eventually die in a dose dependent manner. Animals that receive 10⁵ pfu have a mean day of death of about 14 days, whereas, those inoculated with 10 pfu survive an average of 25 days. With each log 10 increase in virus inoculum, survival time is decreased by about three days. To determine the pathogenesis of MCMV in SCID mice, mice are inoculated with 10 pfu. On each of various days post infection, three mice are euthanized, their tissues removed, homogenized, and assayed for MCMV. Virus is first detected in salivary gland by day six followed by lung, spleen, kidney, adrenals, and pancreas on days 9-12. Liver, which is one of the most permissive organs in normal mice, does not exhibit detectable virus until day 18. In addition, brain is infected by day 18. These data indicate that inoculation of SCID mice with low concentrations of MCMV results in a disseminated infection with viral replication in the same target organs as observed in immunodeficient humans. These animals demonstrate high levels of virus in their tissues for 2-3 weeks, thus allowing adequate time to document an anti-viral response in treated animals compared with placebo animals.

Human CMV infections can cause a wide range of clinical manifestations, especially in the immunocompromised host. Few models exist to study HCMV infection since the virus is host-specific, and infection and replication are limited to human cells. In this regard, a model that involves HCMV infection of fetal human retinal tissue implanted in the eyes of severe combined immunodeficient (SCID) mice can be utilized. Small fragments of fetal human retinas are implanted into the anterior chamber, and four to six weeks after transplantation are inoculated with 2,000 to 10,000 pfu of HCMV. Animals are euthanized and eyes enucleated at various time points after infection. Eyes are prepared for microscopy by sectioning fixed tissue, or are homogenized for detection of infectious HCMV by plaque assay. The model has been validated using GCV, CDV, and other anti-viral therapies. In addition, this model can also be utilized to study and identify the virulence characteristics of HCMV by examining the growth of various HCMV mutants.

The SCID-hu thy/liv implant model can also be used in compound efficacy studies. In this model, small fragments of human fetal thymus and liver are implanted under the kidney capsule in the SCID mouse. Approximately 12-16 weeks later, implants that are fully vascularized and quite large (10-50% the size of the kidney) are inoculated with 10³-10⁴ pfu of HCMV. At various time points after infection, implants are biopsied and homogenized, and HCMV replication is quantified by plaque assay. As with the SCID-hu mouse ocular model, this model can be useful in determining the efficacy of various anti-viral therapies.

Immunocompromised GPCMV Model:

This guinea pig model mimics CMV infection of the immunocompromised host, a common target population of cytomegalovirus infections. Young Hartley guinea pigs are immunossuppressed with cylcophosphamide administered 1 and 7 days prior to viral inoculation with ˜10⁵ pfu salivary gland passaged guinea pig cytomegalovirus (GPCMV). In a typical experiment, two groups of 12 animals each receive the experimental compound or placebo beginning 24 hours after infection. Animals are followed daily for evidence of disease and death which usually occurs by day 14 as described in Bourne et al., Antiviral Research 2000, 47:103-09. Effects on viral replication are measured by sacrificing animals and quantitating virus in specific organs and blood by Real-Time PCR and/or culture. The amount of compound is typically based on an average guinea pig weight of 350-500 g.

Neonatal GPCMV Model:

CMV infection of premature newborns may be life-threatening disease if untreated. The neonatal guinea pig model resembles perinatal CMV infection and allows systematic evaluation of anti-viral compounds in a relatively immature host. In this model, newborn Hartley guinea pigs are infected with ˜10⁶ pfu of salivary gland derived GPCMV 24-48 hours after birth. Anti-viral or placebo treatments, administered orally or by intraperitoneal injection are begun at 0-24 hours after infection. Infection results in decreased weight gain and mortality as high as 70% due to dissemination to target organs such as the liver, spleen and brain by day 10 post-infection (Bravo et al., Antiviral Research 2003, 60:41-49). Animals are followed daily for signs of disease and death. The effects on viral replication are assessed by sacrificing animals and comparing viral titers in various target organs and blood by Real-Time PCR and/or culture. Dosing is typically based on an average newborn guinea pig weight of 100 g.

Congenital GPCMV Model:

CMV is the most common congenital infection. The guinea pig is a small mammal in which virus crosses the placenta to cause fetal infection and disease, thus allowing the study of new anti-virals and unique therapies that may target placental and congenital infection. In this model, Hartley pregnant guinea pigs are infected with ˜10⁵ pfu GPCMV at approximately 45 to 55 days of a 70 day gestation. Animals can be treated by systemic or oral routes. Endpoints include prevention of premature delivery, survival of the offspring and PCR analysis of placenta, and other maternal tissues (blood, liver and spleen) and pup organs (liver and spleen) harvested 3, 5 or 10 days post infection (Bravo et al., Journal of Infectious Diseases 2006, 193:591-7). The dose is typically based on a pregnant guinea pig weight of about 1200 g.

CMV Model of Hearing Loss:

Hearing loss is the most common manifestation of congenital CMV infection. Using direct inoculation of GPCMV (˜10⁵ pfu) into the cochlea through the round window, hearing loss can be induced in guinea pigs as measured by ABR. Animals can then be treated to prevent the hearing loss. Test compounds can be administered either systemically, orally and possibly direct intratympanic administration. Dose is typically based on the weight of the animals, approximately 350 g.

Murine CMV Model:

The murine CMV model is used to study CMV pathogenesis and to evaluate new anti-CMV compounds. In this model, 5-week old female mice are infected with 1×10⁶ pfu of MCMV by intraperitoneal injection. Treatment can begin before or following infection and lasts 3-5 days. Animals are sacrificed at 3 to 5 days after infection and viral titers of the spleen and liver are determined by plaque assay. Other tissues such as salivary gland and lungs can be analyzed as well. Ganciclovir (50 mg/kg, twice daily) serves as a control drug and inhibits MCMV replication in this model. Dosing depends on the weight of the animals, typically about 25 g.

6.7.2 In Vivo Assays for Influenza Viruses

Efficacy:

The influenza animal model consists of an infection of laboratory mice with various strains of influenza A (H1N1, H3N2, H5N1) and B viruses, with the employment of several parameters to measure disease severity. The parameters which can be used include the following: (a) monitoring of blood oxygen saturation (SaO₂) levels in live animals at frequent intervals utilizing pulse oximetry; (b) measuring of infectious pulmonary virus titers using in vitro endpoint dilution assay of homogenates of lungs taken at designated intervals during the infection; (c) assay of the degree of pulmonary consolidation using lungs taken in as determined both by score of lung discoloration and by weight of the lung; (d) death of the animal due to viral pneumonia; (e) mean survival time of the animals; and (f) selected histopathological analysis of lung sections. Where appropriate, studies are conducted to determine the development of viruses resistant to significant anti-viral drugs.

Toxicity:

One or more toxicity determinations are performed on the test compounds under evaluation. These determinations include: (a) lethality; and (b) host weight loss or failure to gain weight. As needed and where applicable, the following additional parameters can also be investigated: (a) increase in circulating serum levels of glutamic oxalic acid transaminase (SGOT) and pyruvic acid transaminase (SGPT) in the serum as markers for possible liver damage; (b) increase in circulating creatinine (CT) level as an indicator of possible renal impairment; and (c) increase in circulating creatinine phosphokinase (CK) levels as indicator of general tissue damage.

6.7.3 In Vivo Assays for Respiratory Viruses

6.7.3.1 RSV, PIV-3, MV and hMPV

Respiratory syncytial virus (RSV), parainfluenza virus type 3 (PIV-3), measles virus (MV) and human metapneumovirus (hMPV) are human pathogens where there is a lack of licensed vaccines for preventing illnesses caused by RSV, PIV-3, or hMPV, although efficacious MV vaccines are available. Ribavirin, immune serum globulins and the humanized monoclonal antibody have been approved for use against some of these paramyxoviruses. However, all of these agents have limitations and can be expensive. Thus, the elucidation and development of new compounds, reagents or vaccines with activity against these viruses are needed. Potential anti-virals and vaccines that can be effective against RSV, PIV-3, MV or hMPV are evaluated in cotton rats. In addition, studies are performed to characterize, enhance or further develop the different paramyxovirus-cotton rat models. Evidence obtained in numerous studies support the usefulness of the different paramyxovirus-cotton rat models for preclinical evaluation of potential paramyxovirus anti-virals and vaccines.

6.7.3.2 SARS Virus

Efficacy:

The SARS virus animal model utilizes weanling mice infected intranasally with the virus. A moderate lung infection is manifested by occasional lung hemorrhaging but primarily by infectious virus recovered from the lungs Inhibition of development of virus in the lungs of the mice is used as parameters for evaluation of test agents.

Toxicity:

One or more toxicity determinations are performed on the test compounds under evaluation. These determinations are: (a) lethality; and (b) host weight loss or failure to gain weight. As needed and where applicable, the following additional parameters can also be investigated: (a) increase in circulating serum levels of glutamic oxalic acid transaminase (SGOT) and pyruvic acid transaminase (SGPT) in the serum as markers for possible liver damage; (b) increase in circulating creatinine (CT) level as indicator of possible renal impairment; and (c) increase in circulating creatinine phosphokinase (CK) levels as indicator of general tissue damage.

6.7.4 In Vivo Assays for Orthopoxviruses

6.7.4.1 Vaccinia and Cowpox Viruses (Smallpox Assay)

The smallpox animal model is an intranasal infection of laboratory mice by the cowpox and vaccinia viruses, which induce an infection of the nose and lungs resulting in a smallpox-like toxemia-associated death. Parameters used in evaluating test compounds in this model include: (a) death of the animal; (b) mean survival time of the animals; (c) lung and nose virus titers; and (d) host weight loss. Other parameters can include: (a) monitoring SaO₂ levels; (b) assay of degree of pulmonary consolidation both by lung score and lung weight increase; and (c) histopathological analysis of lungs and other organs.

Also utilized is a cutaneous infection in immunocompromised hairless mice that can be induced by vaccinia virus. This infection is progressive and leads to the death of the mice. It is now also being used in selected anti-viral experiments. Parameters used in evaluating test agents in this cutaneous infection model include: (a) death of the animal; (b) severity score in initially induced lesions; (c) size of initially induced lesions; (d) number of spontaneous “satellite” lesions; and (e) virus titer in various organs in the animal.

Animal Models for Vaccinia and Cowpox Virus Infections:

Virus Species Route Disease Cowpox Virus (BR) BALB/c Mice i.p. Death - Rapid Liver-Visceral Involvement BALB/c Mice i.n. Death - Slower Lung-respiratory involvement Vaccinia Virus (WR) SKH-1 mice i.d. Skin lesions SCID Mice i.p. Disseminated disease BALB/c Mice i.n. Death Disseminated Disease Vaccinia Virus (IHD) BALB/c Mice i.n. Death Disseminated Disease Vaccinia Virus (WR) SCID Mice i.p. Death Disseminated Disease Vaccinia Virus (NYC) SCID Mice i.p. Death

The causative agent of smallpox, variola virus, cannot be utilized outside a BSL-4 containment area and does not cause disease in adult mice. Various orthopoxviruses can be utilized as surrogate viruses for smallpox including VV and CV. They can be inoculated i.p. or i.n. into SCID mice with an endpoint of death. In normal mice, CV, VV-WR, or VV-IHD, but not VV-Copenhagen Strain, will produce mortality when inoculated by variety of routes. Intranasal inoculation of mice with CV produced an infection with features similar to systemic or disseminated smallpox. Other routes of inoculation such as i.p. or i.v. with VV or CV result in less bronchial involvement and more skin lesions. The IHD strain of VV is less virulent in BALB/c mice than the WR strain. The WR strain of VV produces mortality in BALB/c mice by i.n. inoculation and SCID mice by i.p. inoculation. SKH-1 hairless mice can also be inoculated with VV and CV by inoculation of abraded orofacial areas, similar to the HSV techniques. Mice can be treated systemically or topically with anti-viral compounds for evaluation of efficacy against disease (lesion scores) or viral replication (viral titers).

6.7.4.2 Ectromelia (Mousepox Assay)

Ectromelia virus is the causative agent of mousepox, an acute exanthematous disease of mouse colonies in Europe, Japan, China, and the USA. Laboratory studies have shown ECTV to have a very narrow host range, infecting only certain mouse species. A number of different strains of ECTV have been isolated which have been shown to differ in their virulence for the mouse. The Moscow, Hampstead, and NIH79 strains have been studied, with the Moscow strain being one of the most infectious and virulent for the mouse. Studies in the last five decades have resulted in a detailed description of the virologic and pathologic disease course in genetically susceptible (A, BALB/c, DBA/2, and C3H/He; death ˜7 days post-infection) and resistant (C57BL/6 and AKR) inbred and out-bred mice; identification and characterization of the important cell-mediated and innate responses for recovery from infection; and the discovery of rmp-1, rmp-2, rmp-3 and rmp-4 loci which govern resistance to severe mousepox. Varying mouse genotype, virus strain, and dose of virus result in distinct disease patterns for a given route of infection.

Mousepox differs from smallpox in at least two features following a respiratory tract infection. First, the disease course in mousepox is shorter as compared to smallpox. The eclipse period in mousepox and smallpox are 6 and 10 days, respectively. Fatal cases of mousepox usually occur 7 to 14 days post-infection (p.i.), whereas deaths in ordinary smallpox occur from ˜18 to 22 days p.i. Second, the major lesions in mousepox are observed in the liver and spleen, whereas these organs are relatively uninvolved in smallpox. A feature of mousepox that is similar to smallpox is the relatively small dose of virus that is required to initiate disease in the upper and lower respiratory tract. Another similarity is the detection of virus in respiratory gases during the preexanthem period. Additionally, both diseases present with a characteristic exanthematous rash. In the case of mousepox, the development of rash is dependent on a number of parameters including mouse strain, virus strain, route of inoculation and virus dose.

Efficacy:

An important use of the mousepox model is the evaluation of orthopoxvirus compounds and vaccines. The ECTV aerosol model provides a broad dynamic range for evaluating compounds. An aerosol lethal dose of 100 PFU can be used, which is ˜3-fold greater that the LD₅₀ value of 32 PFU, and is likely in the range of the infectious dose for aerosolized smallpox. Alternatively, a dose 1000 to 10,000 times the LD₅₀ can be used to fully examine the robustness of the test compound.

6.7.4.3 Monkeypox Virus (MPXV)

Animal assays for monkeypox virus (MPXV) can be performed by following the procedures described in, e.g., Americo et al., Journal of Virology, 2010, 84(16): 8172-8180. Generally, the assay is based on an intranasal or intraperitonial infection of CAST/EiJ mice with MPXV, for example, an isolate of Congo Basin Glade of MPXV or West African Glade of MPXV. Upon infection, the animals exhibit loss of weight, morbidity and death in a dose dependent manner. In addition, MPX replication is observed in the lung, spleen and liver of the tested animals.

Consequently, anti-viral efficacy of the test compounds can be assessed by following the criteria such as weight loss, morbidity and death in the presence and absence of the test compounds upon infection with MPXV. Further, replication in organs such as lung, spleen and liver of the animals in the presence and absence of the test compounds upon infection can also be examined to assess the anti-viral efficacy.

6.7.4.4 Rabbitpox Virus (RPV)

Animal assays for rabbitpox virus (RPV) can be performed by following the procedures described in, e.g., Rice et al., Viruses, 2011, 3:63-82, and Adams et al., J. Virol., 2007, 81:11084-11095 ( ). Generally, the model is based on bilateral, intrademal infection of New Zealand White rabbits with 100-1000 pfu of RPV. Upon infection, the animals exhibit weight loss, elevated body temperature (fever), severe respiratory distress, swelling of primary and secondary lesions, eye and nasal discharge and inoculation site necrosis. In addition, viral replication is observed in the respiratory tract. If untreated, the animals are eventually subjected to death (euthanasia) according to euthanasia guidelines.

Consequently, anti-viral efficacy of the test compounds can be assessed by following the criteria described above, including length of survival upon injection and viral replication. In addition, an overall clinical score can be examined to assess the anti-viral efficacy.

Alternatively, animal assays can be based on the procedures described, e.g., in Roy et al., Viruses, 2010, 2:2096-2107, in which similar clinical criteria are examined following an infection through aerosol containing RPV. In this model, experimental infection with RPV initiates with exposure to aerosols with a particle size distribution that is preferential for penetration to the tracheobronchial and pulmonary regions of the lung, with emphasis on the lower respiratory tract.

6.7.5 In Vivo Assays for Papillomaviruses

6.7.5.1 Cottontail Rabbit Papillomavirus (CRPV) Model

The procedures substantially similar to those described, for example, in Christensen, Antiviral Chemistry & Chemotherapy, 2005, 16:283-294 are followed in connection with cottontail rabbit papillomavirus (CRPV) model. In short, topical formulations of the test compound are tested at three doses in groups of 5 rabbits at 4 sites per rabbit. One additional rabbit group includes a placebo treatment. Alternative deliveries include interalesional and systemic treatments depending on the nature of the compound to be tested (e.g., anti-viral, immunomodulator).

Adult New Zealand White rabbits can be purchased from, for example, CoVance, Inc. Rabbits are of both genders. Rabbits are quarantined and cleared (14 days). Each rabbit is inoculated with 10⁻² wtCRPV (4 sites: 2 on the left side of the back (L1 and L2) and 2 on the right side of the back (R1 and R2)) CRPV stock. Combinations of L1, R1, L2 and R2 sites receive treatments. Exemplary treatment schemes are provided below.

-   -   Group A: all 4 sites=placebo ointment;     -   Group B: L1 and L2=GS327422 (0.1%); R1 and R2=GS327422 (0.03%)         -   Treatments are once/week (Monday) for 8 weeks;     -   Group C: L1 and L2=GS327422 (0.1%); R1 and R2=GS327422 (0.03%)         -   Treatments are three times/week (MWF) for 8 weeks; and     -   Group D: L1 and L2=GS327422 (0.1%); R1 and R2=GS327422 (0.03%)         -   Treatments are five times/week (MTWTF) for 8 weeks.

The experiment contains 20 rabbits. Most experiments include 4-5 groups of rabbits (Groups A-E). A placebo group serves as controls to assess local effects of treatment in treated Groups B to D. Vehicle consists of placebo. Groups B-D represents test compound comparisons vs placebo negative control. Doses of compounds are chosen based on various criteria including the past experience. Treatments (topical) begin at a time when the papillomas are visible but not greater than a GMD of 5.0 mm. This time point allows effects on visible papillomas to be assessed, and is a clinically relevant situation. Treatment is once weekly (Group B), 3 times weekly (group C—MWF), and 5 times weekly (MTWTF), for eight weeks with a dose of 0.1 ml per site. Alternatively, treatments may begin 14 days after infection at a time when there are no visible papillomas to maximize the effectiveness of the treatments. Body weights are taken weekly, and sera collected at the end of the treatment period for blood chemistries as needed. Papillomas are measured weekly in 3 axes (length×width×height) in mm. Data are entered into a spread sheet and calculations conducted of the geometric mean diameter of each papilloma, mean±SEM for each group, t-test between each paired groups and plots made of papilloma size vs time. Plots of weight changes are also conducted. At termination, kidney and liver samples are retrieved for histology and toxicity assessment. Skin/papilloma sites are monitored photographically and biopsies assessed for histology at experiment/treatment termination. Serum samples can be collected to conduct blood chemistries to assess any toxicities of the compound under treatment.

6.7.5.2 Mouse Xenograft Model

Subcutanoues and cutaneous mouse xenograft models are schematically described in FIGS. 1 and 2.

6.7.6 In Vivo Assays for Other Viruses

6.7.6.1 Punta Toro Virus

Efficacy:

The Punta Toro virus infection is achieved in C57BL/6 mice and in Syrian golden hamsters, with a generalized disease resembling that induced by Rift Valley fever. Parameters used for anti-viral testing include: (a) death of the animal; (b) hepatic icterus, seen as yellowed liver; (c) elevated ALT levels in serum; (d) virus titers in liver and serum; and (e) host weight loss.

Toxicity:

One or more toxicity determinations are performed on the test compounds under evaluation. These determinations are: (a) lethality; and (b) host weight loss or failure to gain weight. As needed and where applicable, the following additional parameters can also be investigated: (a) increase in circulating serum levels of glutamic oxalic acid transaminase (SGOT) and pyruvic acid transaminase (SGPT) in the serum as markers for possible liver damage; (b) increase in circulating creatinine (CT) level as indicator of possible renal impairment; and (c) increase in circulating creatinine phosphokinase (CK) levels as indicator of general tissue damage.

6.7.6.2 Pichinde Virus

Efficacy:

The Pichinde virus model utilizes Syrian golden hamsters. Parameters used for anti-viral testing include: (a) death of the animal; (b) virus titers in brain, liver, spleen and serum; and (c) elevated ALT levels in serum.

Toxicity:

One or more toxicity determinations are performed on the test substances under evaluation. These determinations are: (a) lethality; and (b) host weight loss or failure to gain weight. As needed and where applicable, the following additional parameters can also be investigated: (a) increase in circulating serum levels of glutamic oxalic acid transaminase (SGOT) and pyruvic acid transaminase (SGPT) in the serum as markers for possible liver damage; (b) increase in circulating creatinine (CT) level as indicator of possible renal impairment; and (c) increase in circulating creatinine phosphokinase (CK) levels as indicator of general tissue damage.

6.7.6.3 VEE Virus

Efficacy: The VEE virus animal model utilizes the TC-83 vaccine strain of virus administered intranasally to C3H/Hen mice; the virus progresses to the central nervous system causing high virus titers in the brain and death of the animal. The Semliki Forest virus model is very similar to that for the Banzi virus, with the same disease parameters. The Semliki Forest virus is a BSL-3-rated pathogen which requires special handling. Parameters for evaluation include: (a) death of the animal; (b) prolongation in mean day to death; (c) virus titers in the brains; and (d) host weight loss.

Toxicity:

One or more toxicity determinations are performed on the test substances under evaluation. These determinations are: (a) lethality; and (b) host weight loss or failure to gain weight. As needed and where applicable, the following additional parameters can also be investigated: (a) increase in circulating serum levels of glutamic oxalic acid transaminase (SGOT) and pyruvic acid transaminase (SGPT) in the serum as markers for possible liver damage; (b) increase in circulating creatinine (CT) level as indicator of possible renal impairment; and (c) increase in circulating creatinine phosphokinase (CK) levels as indicator of general tissue damage.

6.7.6.4 West Nile Virus

Efficacy:

The West Nile virus animal model currently utilizes both mice and hamsters. In each, neurological signs are produced, leading to eventual death of the animals. This virus is a BSL-3-rated pathogen which is recovered from various tissues. Other parameters such as functional abilities are also reviewed. Disease parameters used for anti-viral evaluation include: (a) death of the animal; (b) prolongation on mean day to death; (c) virus titers in brain and other tissues; and (d) host weight loss.

Toxicity:

One or more toxicity determinations are performed on the test substances under evaluation. These determinations are: (a) lethality; and (b) host weight loss or failure to gain weight. As needed and where applicable, the following additional parameters can also be investigated: (a) increase in circulating serum levels of glutamic oxalic acid transaminase (SGOT) and pyruvic acid transaminase (SGPT) in the serum as markers for possible liver damage; (b) increase in circulating creatinine (CT) level as indicator of possible renal impairment; and (c) increase in circulating creatinine phosphokinase (CK) levels as indicator of general tissue damage.

6.7.6.5 Dengue Virus

In vivo assays for DENV can be conducted using procedures substantially similar to those described, for example, in Guabiraba et al., PLoS ONE, 2010, 5(12):e15680 and Souza et al., Proc. Natl. Acad. Sci., 2009, 106(33):14138-14143. DENV virus stock solutions are diluted in endotoxin-free PBS or DPBS to appropriate concentrations. The virus is injected i.p. into mice. Test compounds are given via appropriate routes at appropriate dosing frequency (e.g., twice a day oral administration). Lethality rates are evaluated every 12 hours and other parameters (body weight loss, inflammation, etc.) are checked as appropriate. For tests using knock-out mice, the control typically includes the same test on the wild-type mice. Negative control usually involves the administration of vehicle instead of test compound.

In the case of evaluation of vaccines for DENV virus, assays can be conducted using procedures similar to those described, for example, in Johnson et al., Journal of Virology, 1999, 73(1):783-786. The assay uses IFN deficient mice (e.g., A129 mice, which lack alpha/bea IFN and gamma IFN receptor genes) and involves intraperitoneal administration of DENV into such mice. Typically, IFN deficient mice are universally lethal upon administration of DENV regardless of age. Based on this, criteria such as changes in survival time and rate can be monitored in IFN deficient mice immunized with test vaccine to assess the efficacy of a test vaccine in vivo.

6.7.7 In Vivo Assays for Prion Diseases

Efficacy:

The prion transgenic mouse model utilizes knockout mice for endogenous mouse PrP-sen. These mice express high levels of hamster PrP-sen in a wide range of tissues, including the brain. The animals infected with hamster scrapie agent replace the Syrian hamster model. The latter animals require approximately 120 days to die of the scrapie infection, whereas the prion transgenic mice die in approximately 82 days when infected with the same agent. Death is used as the parameter for anti-prion evaluation.

Toxicity:

One or more toxicity determinations are performed on the test substances under evaluation. These determinations are: (a) lethality; and (b) host weight loss or failure to gain weight. As needed and where applicable, the following additional parameters can also be investigated: (a) increase in circulating serum levels of glutamic oxalic acid transaminase (SGOT) and pyruvic acid transaminase (SGPT) in the serum as markers for possible liver damage; (b) increase in circulating creatinine (CT) level as indicator of possible renal impairment; and (c) increase in circulating creatinine phosphokinase (CK) levels as indicator of general tissue damage.

6.7.8 Other Follow-Up Tests

Follow-up determinations of promising anti-virals seen in the original animal studies can include effect of the administered test compounds on key immunologic components in infected and in uninfected (toxicity control) mice. The immunologic effects studied include: (a) cytotoxic T lymphocyte activity; (b) natural killer cell activity; (c) total T, T-helper, T-suppressor/cytotoxic and B cell enymeration; (d) response to the T-cell mitogen phytohemagglutinin (PHA); (e) production of interferon; and (f) production of neutralizing antibody. Where appropriate, studies are conducted to determine the development of viruses resistant to significant anti-viral drugs.

7. Assays for ELOVL

ELOVL assays can be conducted in vitro using procedures substantially similar to those described in, for example, Shimamura et al., European Journal of Pharmacology, 2010, 630: 34-41.

7.1 In Vitro Assays

7.1.1 Elongation Enzyme Assay

Elongation is carried out using 30 μl of substrate reaction mixture containing 100 mM potassium phosphate buffer (pH 6.5), 200 μM BSA (fatty acid free), 500 μM NADPH, 1 μM rotenone, 20 μM malonyl-CoA, 833 kBq/ml [¹⁴C]malonyl-CoA (GH Healthcare Science, Little Chalfont, UK) and acyl-CoA. The following long chain acyl-CoAs are used as a preferential substrate for each ELOVL: ELOVL1, 10 μM stearoyl-CoA; ELOVL2, 10 μM arachidonoyl-CoA; ELOVL3, 10 μM stearoyl-CoA; ELOVL5, 40 μM arachidonoyl-CoA; and ELOVL6, 40 μM palmitoyl-CoA. To start the reaction, 20 μl of the ELOVL microsomal fraction is added to the substrate mixture, and then incubated for 1 hour at 37° C. with gentle shaking in a 96-well plate. After 1 h incubation, 100 μl of 5 M HCl is added to hydrolyze acyl-CoA, and then the reaction mixture is filtered through a Unifilter-96, GF/C plate (PerkinElmer, Waltham, Mass.) using a FilterMate cell harvester (PerkinElmer, Waltham, Mass.). The 96-well GF/C filter plate is subsequently washed with distilled water to remove excess [¹⁴C] malonyl-CoA and dried, after which 25 μl of MICROSCINT 0 is added to each well and radioactivity determined.

7.1.2 Fatty Acid Elongation Assay in Mouse Hepatocytes

Mouse hepatoma H2.35 cells are grown on 24-well plates in Dulbecco's modified Eagle's medium (DMEM) (Invitrogen, Carlsbad, Calif.) supplemented with 200 nM dexamethason and 4% heat-inactivated fetal bovine serum (FBS) at 33° C. under 5% CO₂ in a humidified incubator. The test compound is dissolved in medium and incubated with subconfluent H2.35 cells for 1 hour at 33° C. [1-¹⁴C]palmitic acid (PerkinElmer Japan, Kanagawa, Japan) is added to each well to a final concentration of 0.8 μCi/ml to detect elongase activity. After 4 hours of incubation at 33° C., the culture medium is removed, and the labeled cells are washed with chilled PBS (3×0.5 ml) and dissolved in 250 μl of 2M sodium hydroxide. The cell lysate is incubated at 70° C. for 1 hour to hydrolyze radiolabeled cellular lipids. After acidification with 100 μl of 5M HCl, fatty acids are extracted with 300 μl of acetonitrile. Radiolabeled palmitic acid (16:0), palmitoleic acid (16:1), stearic acid (18:0), and vaccenic acid:oleic acid (18:1) are quantified by reversed-phase radio-HPLC (RI-HPLC). The identity of the labeled fatty acids is determined by comparing the retention times with known fatty acid standards. Elongation activity was monitored as the elongation index (EI) which was the ratio of radiolabeled C18 (C18:0+C18:1) to C16 (C16:0+C16:1) estimated from each peak area measured by RI-HPLC.

7.2 In Vivo Assays

7.2.1 [¹⁴C]Palmitate Assay in Mouse Liver

The in vivo efficacy of ELOVL6 inhibitor is determined by following the conversion of radiolabeled 116:0 to 16:1, 18:0, and 118:1 in mice. Male C57BL/6J mice are orally administrated with ELOVL6 inhibitor and 1 hour later, the radioactive tracer, [1-¹⁴C] palmitic acid, is interperitoneally administered at 10 μCi/body. For time-course study of the pharmacodynamic effect, [1-¹⁴C]palmitic acid is administered 1, 8 or 12 hours after administration of test compounds. At 1 hour post-dosing of the radioactive precursor, animals are anesthetized with isoflurane (4%) and sacrificed for blood collection from the vena cava. Liver (50 mg) is harvested and incubated in potassium hydroxide/ethanol (2 ml/1.4 ml) at 70° C. for 1 hour. The nonacid-lipid is extracted by 4 ml of petroleum ether and discarded. Fatty acids are extracted by 2 ml of petroleum ether following saponification by 2 ml of 6 M HCl. The ether phase containing the fatty acid fraction is evaporated under nitrogen gas and reconstituted in methanol to measure the radioactivity by RI-HPLC. The radioactivity corresponding to each fatty acid is quantified to calculate the EI.

7.2.2 In Vivo Efficacy in Diet-Induced Obesity (DIO) Mice

Mate C57BL/6J mice are maintained on a high-fat diet with ad libitum access to water (D12492, Research. Diets, Inc., NJ) for 7 months. Mice are orally administered ELOVL6 inhibitor (dissolved in 0.5% methylcellulose) twice daily (09:30 and 18:30) for 14 days at 30 mg/kg dose. At day 13, body composition is determined and an intraperitoneal glucose tolerance test (0.5 kg/g glucose) is performed. At day 14, mice are sacrificed. At 4 hour post-final dosing of ELOVL6 inhibitor, mice are anesthetized and the liver tissues are immediately isolated, weighed, frozen in liquid nitrogen and stored at −80° C. until use. Plasma is prepared and glucose, insulin and leptin are measured using commercially available assay kits (Glucose, KyowaMedex, Tokyo, Japan; leptin and insulin, Morinaga, Tokyo, Japan). Liver tissues are isolated for the measurement of triglyceride contents and fatty acid composition. For hepatic triglyceride contents, isolated tissues are homogenized in 2 ml distilled water, followed by the addition of 6 ml chloroform/methanol (2:1). After centrifugation, the chloroform phase is transferred to a new glass tube containing 1 ml of distilled water and then 3 ml chloroform is added. The lower phase is collected after centrifugation and evaporated to dryness. Extracts are dissolved in 2-propanol and the triglyceride concentration is measured enzymatically (Determiner TGII, Kyowa Medex, Tokyo Japan). For hepatic fatty acid composition, the liver samples are incubated in 100-fold volume (w/v) of 5 M NaOH/ethanol (1:1) at 60° C.,

After 2 hour incubation, 500 μl of 5 MC17:0 (internal standard) are added to all hydrolysates. The fatty acid compositions are analyzed as following. The fatty acids in the tissue hydrolysate are derivatized with 2-nitrophenylhydrazine (2-NPH), and these derivatives are purified using an Oasis FILE column. An aliquot (10 μl) of the eluate is injected into the HPLC apparatus for analysis. HPLC analysis is performed with a Shimazu 10Avp system (Kyoto, Japan), equipped with a UV detector (SPD-10Avp), two pumps (LC-10ADvp), an auto-sampler (SIL-10ADvp), and a column oven (CTO-10ACvp). The mobile phase consist of CH₃CN-water (80:20, flow rate: 0.6 ml/min). The separation is performed with a CAPCELL PAK C18 MGII (2.0 mm i.d.×150 mm, 5 μm) at 35° C. and the UV absorbance is subsequently measured at 400 nm. The elongation index represents the ratio of C18 (C18:0+C18:1) to C16 (C16:0+C16:1) which is quantified from each fatty acid amount.

7.2.3 In Vivo Efficacy in KKAy Mice

Male KKAy mice given a regular diet (CE2, CLEA Japan) are orally administered ELOVL6 inhibitor (dissolved in 0.5% methylcellulose) twice daily (09:30, 18:30) for 28 days at 30 mg/kg dose. At day 21, an intraperitoneal glucose tolerance test (0.5 kg/g glucose) is performed. At day 28, body composition is determined and mice are sacrificed. Plasma parameters, hepatic triglyceride contents, and fatty acid composition are measured as described above.

7.2.4 Pharmacokinetic Studies in Mice

Single doses of test compound at 10 mg/kg body weight are administered orally to C57BL/6J mice by gavage in a vehicle of 0.5% methylcellulose aqueous suspension. Blood samples from the abdominal vein and liver samples are obtained 2 hours after administration. In the case of an in diet regimen, mice are dosed with 100 mg/kg at 17:00 and fed a diet containing 0.13% test compound overnight. Then mice are sacrificed the next morning. Blood samples are centrifuged to separate the plasma. Liver samples are homogenized with phosphate-buffered saline (pH 7.4). Each sample is deproteinized with ethanol containing an internal standard. Test compound and the internal standard are detected by liquid chromatography mass spectrometry/mass spectrometry (Quattro Ultima mass spectrometer, Waters, Milford, Mass.) in positive ionization mode using an electrospray ionization probe, and their precursor to production combinations are monitored using the Multiple Reaction Monitoring mode.

EXEMPLIFICATION

The disclosed compounds can be prepared in a number of ways well known to one skilled in the art of organic synthesis. More specifically, disclosed compounds can be prepared using the reactions and techniques described herein. In the description of the synthetic methods described below, it is to be understood that all proposed reaction conditions, including choice of solvent, reaction atmosphere, reaction temperature, duration of the experiment and workup procedures, can be chosen to be the conditions standard for that reaction, unless otherwise indicated. It is understood by one skilled in the art of organic synthesis that the functionality present on various portions of the molecule should be compatible with the reagents and reactions proposed. Substituents not compatible with the reaction conditions will be apparent to one skilled in the art, and alternate methods are therefore indicated. The starting materials for the examples are either commercially available or are readily prepared by standard methods from known materials.

SYNTHETIC METHODS

General Synthesis

(i) Synthesis of Tetrazolone Intermediate

Step S-1:

A solution of aniline (A) (1.0 equiv) and triethylamine (1.0 equiv) in dry dichloroethane (DCE) (0.2 M) under argon is treated with triphosgene (0.4 equiv) and heated to reflux for 2 hours, or until the reaction is determined to be complete by LCMS or TLC. The reaction is then cooled to room temperature, diluted with dichloromethane, washed with 1N HCl (aq) and brine, dried over MgSO₄, and then filtered and concentrated in vacuo. The desired isocyanate (B) is used in the next step without purification.

Step S-2:

A mixture of the isocyanate (B) (1.0 equiv) and trimethylsilyl azide (2.0 equiv) is heated to reflux for 24 hours, or until the reaction is determined to be complete by LCMS or TLC. The excess of azide is removed in vacuo and the residue is crystallized from toluene or methanol to provide the desired tetrazolone intermediate (C) as a white solid.

(ii) Synthesis of the Amine Intermediate

Step S-3:

Copper iodide (1 equiv) and cesium carbonate (2.0 equiv) are added to a microwave vial, and the vial is evacuated and filled with argon three times. An aryl iodide (D-1) in dry dimethylformamide (0.6 M), an alkyl amine (R¹¹NH₂) (2.0 equiv) and 2-isobutyrylcyclohexanone (0.2 equiv) are then added to the vial, the vial is sealed and the resulting mixture is heated to 100° C. under microwave irradiation for 2 hours, or until the reaction is determined complete by LCMS or TLC. At that time, the vial is cooled to room temperature, and the reaction mixture is diluted with ethyl acetate and filtered through a pad of Celite with the aid of ethyl acetate. The filtrate is washed with brine (3×), dried over MgSO₄, filtered and concentrated in vacuo. The residue is purified by flash chromatography on silica gel (ethyl acetate/hexanes as elutant) to provide the desired amine intermediate (E).

Step S-4:

To a mixture of nitro compound (D-2) (1.0 equiv) and iron (15.0 equiv) in 1:1 absolute ethanol/dry tetrahydrofuran solution (0.8 mL/mmol of ester) is added water (10 uL/ml of solvent). The mixture is then cooled to 0° C. and a solution of concentrated sulfuric acid (4.0 equiv) in water (1.2 ml/mmol of ester) is added dropwise to the mixture. The reaction is warmed to room temperature and stirred for 1 hour, or until the reaction is determined complete by LCMS or TLC. The reaction is then filtered through a pad of Celite® with the aid of ethyl acetate. The filtrate is diluted with brine, saturated aqueous sodium bicarbonate solution and additional ethyl acetate, the organic and aqueous layers are separated, and the organic layer is washed with saturated sodium bicarbonate solution, brine, dried over MgSO₄, filtered and concentrated in vacuo. The residue is purified by flash chromatography on silica gel (ethyl acetate/hexanes as elutant) to provide D-3.

Step S-5:

To a stirred solution of D-3 (1.0 equiv) in acetic acid (0.2 M) is added a carbonyl compound (10.0 equiv of a ketone or aldehyde) and sodium borohydride (10.0 equiv), and the resulting mixture is stirred at room temperature for 1 hour, or until the reaction is determined complete by LCMS or TLC. The reaction is then diluted with ethyl acetate, and washed with saturated aqueous sodium bicarbonate solution (5×) and brine (2×), and the organic layer is dried over MgSO₄, filtered and concentrated in vacuo. The residue is purified by flash chromatography on silica gel (ethyl acetate/hexanes) to provide the desired amine intermediate (E).

(iii) Coupling of Tetrazolone Intermediate and Amine Intermediate

Step S-6:

To a solution of amine intermediate (E) (1.3 equiv) in dry tetrahydrofuran (0.5 M) under argon is added triethylamine (1.3 equiv) followed by triphosgene (0.7 equiv). The resulting heterogeneous mixture is stirred at room temperature for 15 minutes, treated with dimethylaminopyridine (DMAP) (1.0 equiv) and the tetrazolone intermediate (C) (1.0 equiv), diluted with dry tetrahydrofuran (to 0.25 M final concentration with respect to amine) and heated to reflux for 1 hour, or until the reaction is determined to be complete by LCMS or TLC. The reaction mixture is cooled to room temperature and diluted with ethyl acetate and brine, and the aqueous and organic layers are separated. The organic layer is washed with brine, 10% aqueous HCl, then brine, and dried over MgSO₄, filtered and concentrated in vacuo. The residue is purified by flash chromatography on silica gel (ethyl acetate/hexanes) to provide the desired tetrazolone product (F).

(iv) Scope of the General Synthetic Method

The general synthetic method is not intended to be limited to the coupling of amine intermediates such as (E) with phenyl tetrazolone intermediates such as (C) in the formation of compounds provided herein. For example, other amines and tetrazolones have been coupled using the general methods described above to provide a wide variety of tetrazolone compounds, e.g., such as the tetrazolone compounds provided in Tables 1-4.

Exemplary Syntheses of Compounds

(i) Synthesis of Tetrazolone Compounds 7 and 8

Compound 3:

A mixture of commercially available 2,6-difluorophenyl isocyanate (2) (1.0 equiv) and trimethylsilyl azide (2.0 equiv) was heated to reflux for 12 hours. The excess of azide was removed in vacuo and the residue was crystallized from toluene to provide compound (3) as white needles.

Compound 5:

To a solution of commercially available 5-iodo-2-methoxybenzoic acid (4) (1.0 equiv) in dry dimethylformamide (DMF) (0.5 M) under argon was added solid potassium carbonate (1.5 equiv) followed by benzyl bromide (1.1 equiv), and the resulting mixture was stirred at room temperature for 4 hours, acidified with 10% HCl, and diluted with brine and ethyl acetate. The aqueous and organic layers were separated and the organic layer was washed with brine (5×), dried over MgSO₄, filtered and concentrated in vacuo to afford an oil, compound (5), which was used without further purification.

Compound 6:

Copper iodide (1 equiv) and cesium carbonate (2.0 equiv) were added to a microwave vial and the vial was evacuated and filled with argon three times. Compound (5) in dry dimethylformamide (0.6 M), isopropylamine (2.0 equiv) and 2-isobutyrylcyclohexanone (0.2 equiv) were then added to the vial, the vial was sealed and the resulting mixture was heated to 100° C. under microwave irradiation for 2 hours. At that time, the vial was cooled to room temperature and the reaction mixture was diluted with ethyl acetate and filtered through a pad of Celite® with the aid of ethyl acetate. The filtrate was washed with brine (3×), dried over MgSO₄, filtered and concentrated in vacuo. The residue was purified by flash chromatography on silica gel (ethyl acetate/hexanes) to provide compound (6).

Compound 7:

To a solution of compound (6) (1.5 equiv) in dry dichloromethane (0.5 M) under argon was added triethylamine (3.0 equiv) followed by triphosgene (1.5 equiv). The resulting heterogeneous mixture was stirred at room temperature for 15 minutes, concentrated in vacuo, and the residue was taken up in dry toluene (0.25 M with respect to amine) and treated with dimethylaminopyridine (DMAP) (1.0 equiv) and the compound (3) (1.0 equiv). The resulting mixture was heated to reflux for 1 hour, cooled to room temperature and diluted with ethyl acetate and brine, and the aqueous and organic layers were separated. The organic layer was washed with brine, 10% aqueous HCl, then brine, and dried over MgSO₄, filtered and concentrated in vacuo. The residue was purified by flash chromatography on silica gel (ethyl acetate/hexanes) to provide compound (7) as a white foam.

Compound 8:

To a solution of compound 7 (1.0 equiv) in 2:1 methanol/THF (0.1 M) under argon was added 5% Pd/C (0.1 equiv) and the inert atmosphere was replaced with hydrogen. The resulting mixture was stirred at room temperature for 30 minutes, filtered through a pad of Celite with the aid of methanol and the resulting filtrate was concentrated in vacuo. The residue was purified by preparative HPLC (0.1% formic acid in acetonitrile/water) to provide compound (8) as a white solid.

(ii) Synthesis of Tetrazolone Compounds 15 and 16

Compound 10:

To a stirred solution of commercially available compound (9) (1.0 equiv) in 1:1 THF:H₂O (0.6 M) under nitrogen was added LiOH (5.0 equiv) at room temperature. The reaction was heated to 80° C. for two hours. The resulting solution was cooled to room temperature and the volume was reduced by rotary evaporation. The resulting solution was acidified with 2N HCl to pH=1, extracted with ethyl acetate, dried with sodium sulfate, and concentrated via rotary evaporation to provide compound (10) which was advanced without purification.

Compound 11:

To a stirred solution of (10) (1.0 equiv) in 20:1 acetone:DMF (0.2 M) under nitrogen was added potassium carbonate (1.5 equiv), p-methoxybenzyl chloride (1.0 equiv), and sodium iodide (catalytic) at room temperature. The resulting mixture was heated to 70° C. for six hours. The resulting solution was cooled to room temperature and the volume was reduced by rotary evaporation. The resulting solution was diluted with hexanes and ethyl acetate, washed with water, dried with sodium sulfate and concentrated via rotary evaporation. The resulting oil was purified by silica gel column chromatography (hexanes to 25% ethyl acetate/hexanes) to afford compound (11) as an oil.

Compound 12:

To a stirred solution of compound (11) (1.0 equiv) in DMF (0.12M) at room temperature in a microwave vial was added cesium carbonate (2.00 equiv), copper iodide (0.1 equiv), 2-isobutyrylcyclohexanone (0.2 equiv), and cyclohexylamine (3.0 equiv). The resulting suspension was heated in the microwave at 100° C. for 1 hr. The resulting suspension was cooled to room temperature, diluted with ethyl acetate, washed with dilute aqueous lithium chloride, and washed with water. The organic layer was dried with sodium sulfate and concentrated via rotary evaporation to afford a green oil which was purified by silica gel column chromatography (hexanes to 1:2 ethyl acetate/hexanes) to afford compound (12) as an oil.

Compound 14:

To a stirred solution of commercially available compound (13) (1.00 equiv) was added azidotrimethylsilane (4.00 equiv). The resulting suspension was heated at 90° C. for six hours. The hot reaction solution was poured directly into a beaker containing toluene:ice (1:1). The resulting yellow precipitate was collected via vacuum filtration and washed with cold toluene to afford compound (14) as a yellow solid.

Compound 15:

To a stirred solution of compound (12) (1.2 equiv) in dichloromethane (0.5M) at 0° C. was added triethylamine (3.0 equiv) and triphosgene (1.0 equiv). The ice bath was removed and the solution was stirred at room temperature for 15 minutes followed by concentrated by rotary evaporation. The resulting foam was dissolved in toluene (0.4M) followed by addition of compound (14) (1.0 equiv) and dimethylaminopyridine (1.0 equiv). The resulting suspension was heated at 70° C. for sixteen hours. The solution was cooled to room temperature, diluted with ethyl acetate, and washed with water. The organic layer was dried with sodium sulfate and concentrated via rotary evaporation. The resulting oil was purified by silica gel column chromatography (ethyl acetate/hexanes) to afford compound (15) as a white solid.

Compound 16:

To a stirred solution of compound (15) (1.0 equiv) in CH₂Cl₂ (0.1 M) under nitrogen was added trifluoroacetic acid (10.0 equiv) followed by anisole (1.0 equiv) at room temperature. The reaction was run at room temperature for ten minutes. The reaction was diluted with dichloromethane and neutralized with aqueous sodium bicarbonate solution. The organic layer was dried with sodium sulfate and concentrated via rotary evaporation. The resulting oil was purified by preparative HPLC (0.1% formic acid in acetonitrile/water) and lyophilized to give compound (16) as a white powder.

(iii) Synthesis of Tetrazolone Compounds 17 and 18

Compound 17:

To a stirred solution of compound (16) (1.0 equiv) in MeOH (0.02 M) under nitrogen was added palladium hydroxide on carbon (0.2 equiv) followed by vacuum evacuation and exposure to hydrogen gas (1 atm, balloon). The reaction was run at room temperature overnight. The resulting solution was filtered thru celite, washed with dichloromethane and concentrated via rotary evaporation. The resulting oil was purified by preparative HPLC (0.1% formic acid in acetonitrile/water) and lyophilized to afford compound (17) as a white solid.

Compound 18:

To a stirred solution of compound (17) was added formic acid (500 equiv). The reaction was heated at 100° C. for 1 hour. After cooling to room temperature, the reaction was diluted with ethyl acetate and the organic layer was washed with water, dried with sodium sulfate, and concentrated via rotary evaporation. The resulting oil was purified by preparative HPLC (0.1% formic acid in acetonitrile/water) and lyophilized to afford compound (18) as a white solid. Compound (18) is depicted above as one compound, but it exists in equilibrium as a mixture of tautomers as shown below.

(iv) Synthesis of Tetrazolone Compounds 24 and 25

Compound 20:

To a solution of commercially available 4-oxocyclohexanecarboxylic acid (19) (1.0 equiv) in dry DMF (0.5 M) under argon was added solid potassium carbonate (1.5 equiv) followed by benzyl bromide (1.1 equiv). The resulting mixture was stirred at room temperature for 4 hours, acidified with 10% HCl, diluted with brine and ethyl acetate, and the layers were separated. The organic layer was washed with brine (5×), dried (MgSO₄), filtered and concentrated in vacuo to afford a solid which was used without further purification.

Compound 21:

A solution of benzyl 4-oxocyclohexanecarboxylate (20) (1.0 equiv) and a 2-Methylamine solution in THF (2.0 equiv) in dry DCE (1.4 M) under argon was treated with sodium triacetoxyborohydride (1.5 equiv) and the resulting mixture was stirred at rt for 1 h, and quenched with saturated aqueous sodium bicarbonate solution. The layers were separated and the aqueous one extracted with DCM (3×). The combined organic layers were washed with brine, dried (MgSO₄), filtered and concentrated in vacuo. The residue was purified by flash chromatography on silica gel (ethyl acetate/hexanes) to provide compound (21) as an oil.

Compound 23:

A mixture of commercially available 2,6-dichlorophenyl isocyanate (22) (1.0 equiv) and trimethylsilyl azide (2.0 equiv) was heated to reflux for 12 hours. The excess of azide was removed in vacuo and the residue was crystallized from methanol to provide compound (23) as white needles.

Compound 24:

To a solution of compound (21) (1.3 equiv) in dry tetrahydrofuran (0.5 M) under argon was added triethylamine (1.3 equiv) followed by triphosgene (1.3 equiv). The resulting heterogeneous mixture was stirred at room temperature for 15 minutes diluted with dry tetrahydrofuran (0.25 M with respect to amine) and treated with DMAP (1.0 equiv) and compound (23) (1.0 equiv). The resulting mixture was heated to reflux for 1 hour, cooled to room temperature and diluted with ethyl acetate and brine, and the aqueous and organic layers were separated. The organic layer was washed with brine, 10% aqueous HCl, then brine, and dried over MgSO₄, filtered and concentrated in vacuo. The residue was purified by flash chromatography on silica gel (ethyl acetate/hexanes) to provide compound (24) as a white solid.

Compound 25:

To a solution of compound (24) (1.0 equiv) in methanol (0.1 M) under argon was added 10% Pd(OH)₂ on carbon (0.1 equiv) and the inert atmosphere was replaced with hydrogen. The resulting mixture was stirred at room temperature for 2 h, filtered through a pad of Celite with the aid of methanol, and the resulting filtrate concentrated in vacuo. The residue was purified by preparative HPLC (0.1% formic acid in acetonitrile/water) to provide compound (25) as a white solid.

(v) Synthesis of Tetrazolone Compounds 27 and 28

Compound 27:

Commercially available tert-butyl piperidin-3-ylcarbamate (26) (1.3 equiv) in dry tetrahydrofuran (0.5 M) under argon was added triethylamine (1.3 equiv) followed by triphosgene (1.3 equiv). The resulting heterogeneous mixture was stirred at room temperature for 15 minutes, diluted with dry tetrahydrofuran (0.25 M with respect to amine) and treated with DMAP (1.0 equiv) and compound (23) (1.0 equiv). The resulting mixture was heated to reflux for 1 hour, cooled to room temperature and diluted with ethyl acetate and brine, and the aqueous and organic layers are separated. The organic layer was washed with brine, 10% aqueous HCl, then brine, and dried over MgSO₄, filtered and concentrated in vacuo. The residue was used without further purification. An analytical sample was obtained by preparative HPLC (0.1% formic acid in acetonitrile/water) to provide compound (27) as a white solid.

Compound 28:

Compound (27) (1.0 equiv) was dissolved in dry dichloromethane (0.2 M) at 0° C. and was treated dropwise with TFA (3:1 DCM/TFA). The resulting solution was stirred at room temperature for 1 h and was concentrated in vacuo. The amine salt was then taken up in dry dichloromethane, cooled to 0° C. and treated with excess of acetyl chloride (10.0 equiv) and triethylamine (1.0 equiv). The resulting mixture was stirred at 0° C. for 15 min, quenched with 10% HCl and extracted with DCM (2×). The combined organic extracts were washed with brine, dried (MgSO₄), filtered and concentrated in vacuo. The residue was purified by preparative HPLC (0.1% formic acid in acetonitrile/water) to provide compound (28) as a white solid.

(vi) Synthesis of Tetrazolone Compounds 32 and 33

Compound 30:

To a stirred solution of 5-amino-2-pyridinecarboxylic acid (29) (1.0 equiv) in AcOH (0.9 M) under nitrogen was added cyclohexanone (1.1 equiv) and sodium triacetoxyborohydride (1.1 equiv) at room temperature. The resulting mixture was stirred at room temperature for 72 hours. Methanol was added and the resulting solution was concentrated by rotary evaporation. The resulting oil was dissolved in CHCl₃:IPA (4:1) and water, and the organic layer was concentrated in vacuo to provide compound (30) which was advanced without purification.

Compound 31:

To a stirred solution of compound (30) (1.0 equiv) in 2:1 CH₂Cl₂:DMSO (0.13M) was added AgO (3.0 equiv) followed by benzyl bromide (1.1 equiv). The reaction was run at room temperature overnight. The resulting solution was filtered through a celite pad, diluted with CH₂Cl₂, washed with water, dried with sodium sulfate, and concentrated by rotary evaporation. The resulting oil was purified by silica gel chromatography (hexanes to 50% ethyl acetate/hexanes) to afford compound (31) as an off-white foam.

Compound 32:

To a stirred solution of compound (31) (0.9 equiv) in dichloromethane (0.5M) at 0 C was added triethylamine (3.0 equiv) and triphosgene (1.0 equiv). The ice bath was removed and the solution was stirred at room temperature for 15 minutes followed by concentrated by rotary evaporation. The resulting foam was dissolved in toluene (0.4M) followed by addition of compound (3) (1.0 equiv) and dimethylaminopyridine (1.0 equiv). The resulting suspension was heated at 90° C. for two hours. The solution was cooled to room temperature, diluted with ethyl acetate, and washed with water. The organic layer was dried with sodium sulfate and concentrated via rotary evaporation. The resulting oil was purified by silica gel column chromatography (hexanes to 50% ethyl acetate/hexanes) to afford compound (32).

Compound 33:

To a stirred solution of (32) (1.00 equiv) in methanol (0.1M) at room temperature was added 20% palladium hydroxide on carbon (˜0.2 equiv). The reaction was evacuated and flushed with nitrogen followed by charging with hydrogen gas. After stirring for one hour, the reaction was filtered through celite, washed with dichloromethane, and concentrated by rotary evaporation. The resulting oil was purified by silica gel column chromatography (dichloromethane to 9:1 dichloromethane:methanol) to afford 33 as a clear oil.

(vii) Synthesis of Tetrazolone Compounds 40 and 41

Compound 36:

To a stirred suspension of commercially available compound (34) (1.0 equiv) and potassium carbonate (1.5 equiv) in dry DMF (0.3 M) under nitrogen was added benzyl bromide (1.2 equiv) at room temperature. The reaction was stirred for 19 hours, additional potassium carbonate (1.5 equiv) was added followed by phenol (1.2 equiv) and stirring was continued for 24 h. The resulting suspension was filtered through a pad of Celite with aid of AcOEt, the filtrate was diluted with additional AcOEt and was washed with brine and 10% HCl. The aqueous layer was back-extracted with AcOEt and the combined organic layers were washed with brine (3×), dried (MgSO₄), filtered and concentrated in vacuo. An orange oil was obtained, which was purified by flash chromatography (Hexane/AcOEt 9:1) to render compound 36 as a thick yellow oil (90% yield).

Compound 37:

To a stirred solution of (36) (1.0 equiv) and iron powder (15.3 equiv) in 1:6 absolute EtOH/THF (0.3 M) cooled to 0° C., was dropwise added a solution of H₂SO₄ (0.6 ml/mmol) in H₂O (1.8 ml/mmol). The resulting mixture was stirred at rt for 1 h, filtered through a pad of Celite with the aid of AcOEt, and the filtrate diluted with brine and additional AcOEt. The layers were separated, the organic one was washed with brine, saturated sodium bicarbonate solution, brine, dried (MgSO₄), filtered and concentrated in vacuum. Compound (37) was obtained as a pale yellow oil which crystallized upon standing.

Compound 38:

To an stirred suspension of aniline (37) in glacial AcOH (0.3M) was added acetone (5 equiv) followed by sodium borohydride (2 equiv). The resulting mixture was stirred at rt for 1 h, diluted with AcOEt and washed with brine (3×), saturated sodium bicarbonate solution (6×, until basic pH) and brine (2×). The organic layer was dried (MgSO₄), filtered and concentrated in vacuo. Compound (38) was obtained as an oil after purification by flash chromatography (Hexane/AcOEt 91 to 3:1) (80% yield over 2 steps).

Compound 40:

To a stirred solution of compound (38) (1.0 equiv) in dichloromethane (0.3 M) at 0° C. was added triethylamine (2.0 equiv) and triphosgene (0.7 equiv). The ice bath was removed and the solution was stirred at room temperature for 15 minutes and was concentrated in vacuo. The resulting foam was dissolved in toluene (0.3 M) followed by addition of compound (39) (1.1 equiv) and dimethylaminopyridine (1.0 equiv). The resulting suspension was heated to reflux for 3 h, was then cooled to room temperature, diluted with ethyl acetate, and washed with water, 10% hydrochloric acid solution and brine. The organic layer was dried (MgSO₄), filtered and concentrated in vacuo. The resulting crude was purified by flash chromatography (Hexane/AcOEt 5:1 to 2:1) to afford compound (40) as a pale yellow foam (66% yield).

Compound 41:

To a solution of compound (40) (1.0 equiv) in 1:1 methanol/AcOEt (0.3 M) under argon was added 10% Pd/C (0.15 equiv) and the inert atmosphere was replaced with hydrogen. The resulting mixture was stirred at room temperature for 30 minutes, filtered through a pad of Celite with the aid of methanol and the resulting filtrate was concentrated in vacuo. The residue was purified by flash chromatography (Hexane/AcOEt 2:1 to 1:4 and DCM/MeOH 9:1) to provide compound (41) as a white foam (58% yield) [M+1]⁺=495.1.

(viii) Synthesis of Tetarzolone Compounds 51 and 52

Compound 44:

Compound (44) was prepared in 64% yield via methylation of commercially available 4-fluorosalicilic acid (42) followed by nitration as described in the literature (Del Corona, L.; Signorelli, G.; Pinzetta, A.; Coppi, G. Eur. J. Med. Chem. 1993, 28: 419-425).

Compound 45:

To a solution of compound (44) (1.0 equiv) in dry DMF (0.9 M) was added phenol (1.1 equiv) and potassium carbonate (1.5 equiv) and the resulting mixture was stirred at rt for 1 h, the solid filtered and washed with AcOEt, the filtrate further diluted with AcOEt and washed with 10% HCl and brine (5×). The aqueous layer was back-extracted with AcOEt, which was washed with brine. The combined organic layers were dried (MgSO₄), filtered and concentrated in vacuo. Compound (45) was obtained as an oil, which was used directly.

Compound 46:

A solution of methyl ester (45) (1.0 equiv) in 2:2:5 MeOH/THF/H₂O (0.3 M) was added LiOH (1.5 equiv). The suspension was stirred at 60° C. for 1.5 h. The reaction mixture was allowed to cool to rt, diluted with brine and extracted with diethyl ether. The aqueous layer was acidified with 10% HCl and extracted with AcOEt (3×). The combined AcOEt layers were washed with brine, dried (MgSO₄), filtered and concentrated in vacuo. Compound 46 was obtained as a pale yellow foam, which was used directly.

Compound 47:

To a stirred solution of acid (46) (1.0 equiv) and potassium carbonate (1.5 equiv) in dry DMF (0.6 M) under nitrogen was added benzyl bromide (1.1 equiv) at room temperature. The reaction was stirred for 19 hours, filtered through a pad of Celite with aid of AcOEt, the filtrate was acidified with 10% HCl, diluted with brine and extracted with AcOEt (3×). The combined organic extracts were washed with brine, dried (MgSO₄), filtered and concentrated in vacuo. The residue (oil) was used directly.

Compound 48: To a stirred solution of (47) (1.0 equiv) in 2:1 THF/AcOH (0.6 M) cooled to 0° C., was portionwise added zinc powder (10.0 equiv). The resulting mixture was stirred at 0° C. for 1 h, filtered through a pad of Celite with the aid of AcOEt and the filtrate was diluted with brine and additional AcOEt. The layers were separated, the organic one was washed with brine, saturated sodium bicarbonate solution, brine, dried (MgSO₄), filtered and concentrated in vacuo. Compound (48) was obtained as a pale yellow oil which crystallized upon standing.

Compound 49:

To an stirred suspension of aniline (48) in glacial AcOH (0.3 M) was added cyclohexanone (4.0 equiv) followed by sodium borohydride (2.5 equiv). The resulting mixture was stirred at rt for 1 h, diluted with AcOEt and washed with brine (3×), saturated sodium bicarbonate solution (6×, until basic pH) and brine (2×). The organic layer was dried (MgSO₄), filtered and concentrated in vacuo. The residue was purified by flash chromatography (Hexane/AcOEt 9:1) to give compound (49) as an oil (46% yield over 5 steps).

Compound 51:

To a stirred solution of compound (49) (1.0 equiv) in dichloromethane (0.2 M) at 0° C. was added triethylamine (2.0 equiv) and triphosgene (0.7 equiv). The ice bath was removed and the solution was stirred at room temperature for 15 minutes and was concentrated in vacuo. The resulting foam was dissolved in toluene (0.2 M) followed by addition of compound (50) (1.1 equiv) and dimethylaminopyridine (1.0 equiv). The resulting suspension was heated to reflux for 2 h, was then cooled to room temperature, diluted with ethyl acetate, and washed with water, 10% hydrochloric acid solution and brine. The organic layer was dried (MgSO₄), filtered and concentrated in vacuo. The resulting product was purified by flash chromatography (Hexane/AcOEt 9:1 to 2:1) to afford compound (51) as a crystalline solid (22% yield).

Compound 52:

To a solution of compound (51) (1.0 equiv) in 1:1 methanol/THF (0.1 M) under argon was added 10% Pd/C (0.15 equiv) and the inert atmosphere was replaced with hydrogen. The resulting mixture was stirred at room temperature for 1 h, filtered through a pad of Celite with the aid of methanol and the resulting filtrate was concentrated in vacuo. Compound (52) was obtained as a crystalline solid (99% yield).

BIOLOGICAL ASSAYS

Preparation of Human FASN Protein

Human FASN protein (SEQ ID NO. 1) was purified from SKBR3 cells using procedures modified from those in Jayakumar et al., PNAS 1995, 92:8695-8699. SKBR3 cells were obtained from ATCC and grown in DMEM high glucose medium supplemented with 10% FBS, 1 μg/mL bovine pancreas insulin, 100 U/mL penicillin and 100 μg/mL streptomycin. The confluent cells were trypsinized and washed three times with PBS buffer before frozen in liquid N₂ and stored at −80° C. Frozen cells were thawed on ice and resuspended in lysis buffer (25 mM Tris-HCl, pH 7.0, 15 mM NaCl, 1 mM EDTA, and 1 mM DTT) with protease inhibitors. The cells were lysed by sonication, and the cell debris was removed by centrifugation at 20,000 rpm for 30 min. To the supernatant, neutralized saturated ammonium sulfate solution was added to a final concentration of 35%. The solution was left on ice for 1 hr, and the precipitated proteins were harvested by centrifugation at 20,000 rpm for 30 min. The proteins were redissolved in lysis buffer without NaCl and loaded on a mono Q column. Bound proteins were eluted with a linear gradient of NaCl in lysis buffer. Each fraction was analyzed by SDS-PAGE and FASN NADPH consumption assay. The fractions containing FASN were pooled and concentrated to 2-3 mg/mL. Glycerol was added to 20%, and the protein was frozen in liquid N₂ and stored at −80° C.

FASN NADPH Consumption Assay

All chemicals were purchased from Sigma (St. Louis, Mo.). The procedures of NADPH consumption assay were similar to those described in Cox et al., PNAS 1983, 80:4233-4237. On a 96-well polypropylene microplate, dilution series (typical concentrations 60 nM-1.0 mM) of test compounds were prepared in DMSO, of which 4.0 μL each was transferred to a black polystyrene assay microplate and mixed with 36 μL FASN assay buffer (50 mM potassium phosphate, pH 7.0, 1.0 mM EDTA, 0.01% NP-40) plus 5.0 mM fresh DTT. FASN protein (40 μL 150 nM FASN) was added per well, and the microplate was incubated at 37° C. for 30 min. Enzyme activity measurement was initiated by addition of 20 μL 5× substrate mixture to final concentrations of 60 nM FASN, 2.4 nM-40 μM compound, 0.2 mM NADPH, 50 μM butyryl-CoA, 0.5 mM malonyl-CoA in 100 μL assay buffer plus 5.0 mM DTT and 4.0% DMSO. NADPH consumption was monitored kinetically by fluorescence (λ_(Ex)=340 nm, λ_(Em)=460 nm) on an EnVision 2100 multilabel plate reader (Perkin Elmer, Waltham, Mass.). FASN enzyme activity (slope) in the presence of 4% DMSO was used as maximum control, whereas background (minimum control) was measured by omission of malonyl-CoA in the substrate mixture. Inhibition curves were fitted by a logistic function to yield IC₅₀ values:

${\%\mspace{14mu}{Inhibition}} = {\left\lbrack {1 - \frac{\left( {{Slope} - {Min}} \right)}{\left( {{Max} - {Min}} \right)}} \right\rbrack \times 100\%}$ ${\%\mspace{14mu}{Inhibition}} = \frac{100}{1 + \left( {{IC}_{50}/\lbrack I\rbrack_{total}} \right)^{{Hill}\mspace{14mu}{coefficient}}}$

Compounds provided herein were found to inhibit FASN activity using this assay.

Activities obtained by the above-described FASN NADPH Consumption Assay are designated in Tables 1, 2, 3 and 4 with a star (*), wherein “A*” refers to compounds having an IC₅₀ of less than 60 nM; “B*” refers to compounds having an IC₅₀ of 60 nM to 250 nM, inclusive; “C*” refers to compounds having an IC₅₀ of greater than 250 nM to 1000 nM, inclusive; “D*” refers to compounds having an IC₅₀ of greater than 1000 nM to 10,000 nM, inclusive; and “E*” refers to compounds having an IC₅₀ of greater than 10,000 nM.

FASN Scintillation Proximity Flashplate Assay

Acetyl-coenzyme A, malonyl-coenzyme A, NADPH, bovine gamma globulin, and ORLISTAT were purchased from Sigma (St. Louis, Mo.). Tris(2-carboxyethyl) phosphine hydrochloride (TCEP) was purchased from Pierce Biotechnologies (Rockford, Ill.). [³H]-acetyl-coenzyme A was purchased from Moravek Biochemicals (Brea, Calif.). FlashPlate® PLUS phospholipid 96-well scintillant coated microplates were purchased from Perkin Elmer Life and Analytical Sciences (Shelton, Conn.). The method of the FASN Scintillation Proximity FlashPlate assay is similar to that described in Weiss and Glickman Assay Drug Dev Technol 2003, 1:161-6. In a 96-well polypropylene microplate, a dilution series (typical concentrations 60 nM-1.0 mM) of test compounds were prepared in DMSO followed by a 20-fold dilution into FASN assay buffer (50 mM potassium phosphate, pH 7.0, 1.0 mM EDTA, 0.01% NP-40), of which 5.0 μL each was transferred to a FlashPlate® PLUS 96-well plate and mixed with 35 μL FASN assay buffer plus 0.5 mg/mL bovine gamma globulin and 1 mM TCEP. FASN protein (10 μL, 10 nM) was added per well, and the microplate was incubated at 37° C. for 30 min. 10 μL of 20 mM NADPH was added, and the reaction was initiated by addition of 40 μL substrate mixture to final concentrations of 1 nM FASN, 100 μM acetyl-coenzyme A, 6 μCi [³H]-acetyl-coenzyme A, 300 μM malonyl-coenzyme A, 2 mM NADPH, 0.5 mg/mL bovine gamma globulin, and 1 mM TCEP in a volume of 100 μL per well. Assay plates were incubated for 2 hr at 37° C. and the reaction was stopped with 2 μL of 2.5 mM stock solution of ORLISTAT in DMSO to ˜50 μM. The plates were read in a Wallac 1450 Microbeta Plus liquid scintillation counter (Perkin Elmer, Waltham, Mass.), and counts per minute (CPM) were collected over 2 min. Each inhibitor well CPM was compared to the maximum FASN enzyme activity (Max) CPM and the background (Min) CPM, as measured by omission of FASN enzyme in the background well. % Inhibition values were calculated, and curves were fitted by a four-parameter logistic function to yield IC₅₀ values:

${\%\mspace{14mu}{Inhibition}} = {\left\lbrack {1 - \frac{\left( {{Inhibitor} - {Min}} \right)}{\left( {{Max} - {Min}} \right)}} \right\rbrack \times 100\%}$

Compounds provided herein were found to inhibit FASN activity using this assay.

Activities obtained by the above-described FASN Scintillation Proximity Flashplate Assay are provided in Tables 1, 2, 3 and 4 wherein “A” refers to compounds having an IC₅₀ of less than 15 nM; “B” refers to compounds having an IC₅₀ of 15 nM to 100 nM, inclusive; “C” refers to compounds having an IC₅₀ of greater than 100 nM to 200 nM, inclusive; “D” refers to compounds having an IC₅₀ of greater than 200 nM to 5000 nM, inclusive; and “E” refers to compounds having an IC₅₀ of greater than 5000 nM.

FASN Cellular Flashplate Assay

Compound was added to HCT116 cells 24 hours post-plating (1×10^6 cells per well, 6-well plates) and incubated for 24 hours (37 C, 5% CO₂). Cell pellets were harvested and washed with PBS. 30 uL FAS buffer minus BGG (50 mM KPB, pH 7.0, 1.0 mM EDTA, 0.01% NP-40, 1 mM TCEP) was added to the cell pellet, and the cells were lysed by freeze/thaw (3×, liquid nitrogen/42 C water bath) before pelleting debris (20,000 rcf, 15 minutes, 4 C). Total protein concentration of the lysates were determined (Pierce BCA Total Protein assay, BSA standard) and samples were normalized to 1 mg/mL total protein in assay buffer.

Assay setup: 50 uL assay buffer was added to each well of the FlashPlate (PerkinElmer, FlashPlate Plus Phospholipid 96-well scintillant coated microplate). To the wells 10 uL of each of the following were added; 1 mM Acetyl-CoA, 3 mM Malonyl-CoA, 0.05 mCi/mL [³H]Acetyl-CoA and 20 mM NADPH for final concentrations of 100 uM Acetyl-CoA, 300 uM Malonyl-CoA, 0.5 uCi/well [³H]Acetyl-CoA and 2000 uM NADPH. Finally, 10 uL of FAS enzyme was added to the wells either in the form of HCT116 cell lysate or purified FAS for a standard curve. The FlashPlate was incubated at 37° C. for 120 min then read on the MicroBeta instrument.

Compounds provided herein were found to inhibit FASN activity using this assay.

HCV-Replicon Luciferase Assay

DMEM complete medium (Life Technologies) was supplemented with 10% FCS, 2 mM glutamin, penicillin and streptomycin, and 1× nonessential amino acids and pre-warmed in a 37° C. thermostat water bath for use as a growth medium.

A dish containing HCV-replicon reporter cells, which were kept in a 37° C. CO₂ incubator, was removed from the incubator. The medium was aspirated, and cells were rinsed with 1 ml PBS. The solution was discarded, and 1 ml of 1.25% trypsin/0.02% EDTA was added to additionally rinse the cells. The trypsin/EDTA solution was removed with a vacuum pump, and the cells were incubated at 37° C. for 3 to 5 minutes. Cell morphology was examined under an inverted microscope until a single cell suspension was clearly visible, then the cell was suspended with 3 ml of complete medium by gentle pipetting.

Upon suspension, cell numbers were counted with a hematometer, and cell density was adjusted to 100K/ml by adding appropriate volume of the complete medium. One hundred microliters (100 μl) of cell suspension was added to each well of a 96-well white plate to provided cell density of each of the wells to be 10K/well. The 96-well assay plate was placed in a 37° C. 5% CO₂ incubator for 24 hours.

At the end of the incubation, the plate was removed and test compound was added at various desired concentrations using a serial dilution. The plate was placed back into the 37° C. CO₂ incubator for 48 hours. After the incubation, 30 μl of Stead-Glo Luciferase System® (Promega) reagent was added to each well and mixed by gentle shaking for 5 minutes to allow thorough cell lysis. Luminescence was measured with Envision® (Perkin-Elmer) with an integration time of 2 seconds.

The tests were conducted using the following compounds:

From this test, it was found that IC₅₀ values for HCV-replicon of the tested compounds range from about 4 nM to about 7.3 μM. These results indicate that compounds provided herein are effective inhibitors of HCV.

MTT Assay

DMEM complete medium (Life Technologies) was supplemented with 10% FCS, 2 mM glutamin, penicillin and streptomycin, and 1× nonessential amino acids and pre-warmed in a 37° C. thermostat water bath for use as a growth medium.

A dish containing HCV-replicon cells, which were kept in a 37° C. CO₂ incubator, was removed from the incubator. The medium was aspirated, and the cells were rinsed with 1 ml PBS. The solution was discarded, and 1 ml of 1.25% trypsin/0.02% EDTA was added to additionally rinse the cells. The trypsin/EDTA solution was removed with a vacuum pump, and the cells were incubated at 37° C. for 3 to 5 minutes. Cell morphology was examined under an inverted microscope until single cell suspension was clearly visible, then the cell was suspended with 3 ml of complete medium by gentle pipetting.

Upon suspension, cell numbers were counted with a hematometer, and cell density was adjusted to 100K/ml by adding appropriate volume of the complete medium. One hundred microliters (100 μl) of cell suspension was added to each well of a 96-well white plate to provided cell density of each of the wells to be 10K/well. The 96-well assay plate was placed in a 37° C. 5% CO₂ incubator for 24 hours.

At the end of the incubation, the plate was removed and test compound was added at various desired concentrations using a serial dilution. The plate was placed back into the 37° C. CO₂ incubator for 48 hours. After the incubation, 10 μl of 5 mg/ml 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) was added to each well, and the mixture was incubated in the 37° C. CO₂ incubator for 4 hours. One hundred microliters (100 μl) of testing solution (10% SDS+5% isobutyl alcohol+10 mmol/l HCl) was added directly to each well, and the mixture was incubated in the 37° C. 5% CO₂ incubator overnight. Absorbance at 580/680 nm was measured on SpectraMax Plus 384® (MDC).

C¹³ Palmitate Assay

HCT-116 tumor cells (ATCC) were labeled for 24 hours in Dulbecco's minimum Eagle's medium supplemented with 0.5 g/liter [U—¹³C] glucose (Cambridge Isotope Laboratories) and 2.0 g/liter unlabeled glucose (Sigma). Cells were concurrently treated with test compounds at 0.2% DMSO. After 24 hours, cells were harvested with trypsin/EDTA, counted by hemacytometer, washed with PBS, and centrifuged at 2000 rpm for 5 minutes. Pellets of 5M cells were stored at −80° C.

The cell pellet was saponified in strong base overnight at 70° C. The media was acidified and the palmitic acid extracted with hexanes. After drying the hexane layer, the palimitic acid was reconstituted in methanol that had been made slightly acidic. The palmitic acid was then monitored for C¹³ incorporation via GCMS. Palmitic acid synthesis was deemed to have been halted if no C¹³ was incorporated into the palmitate. Unhindered palmitate synthesis was determined by the amount of C¹³ incorporated in absence of test compound.

Compounds provided herein were found to inhibit palmitate synthesis using this assay.

PHARMACOKINETIC STUDIES

Distribution Upon Oral Administration

Prior to the beginning of the tests, a study was conducted to determine if perfusion of the livers is necessary for an accurate quantification of levels of test compounds in the liver. If necessary, animals were perfused prior to liver collection. Additionally, a single dose 24-hour tolerability study was conducted on a few animals to verify that a given level of test compound is tolerated.

To the animals, single oral (PO) dose was administered at a volume of 10 ml/kg based on most recent body weight. Twenty milligrams per milliliter (20 mg/ml) of test compound in 0.5% Carboxymethylcellulose/5% DMSO/0.5% Tween was used. Vehicle control was also included.

At 0, 15, 30, 60, 120, 240, 360, 480 & 1440 minutes after dose administration, 3 animals from each group were anesthetized by carbon dioxide inhalation and euthanized by cardiac puncture. Blood was collected into lithium heparin vacutainers, placed on wet ice and centrifuged at 4° C. within 15 minutes of collection at 10,200 rpm for 5 minutes. Plasma was collected into a fresh eppendorf tube, frozen on dry ice and stored at −80° C. until PK analysis. Livers were harvested and bisected. Half of each tumor was snap-frozen in liquid nitrogen in pre-weighed Genogrinder tubes, placed on dry ice and stored at −80° C. until pharmacokinetic analysis, and the other half was snap-frozen in liquid nitrogen in pre-weighed Genogrinder tubes, placed on dry ice, and stored at −80° C. until PD analysis.

INHIBITION OF HUMAN FASN

Scintillation Proximity Flashplate Assay and NADPH Consumption Assay

Compounds prepared following the above described synthetic methods are provided in Tables 1-4 below. Substituent abbreviations used in Tables 1-4 are given in Table 5. Compounds were assayed as inhibitors of human FASN using the above-described FASN Scintillation Proximity Flashplate Assay (IC₅₀; nM) or FASN NADPH Consumption Assay (*) (IC₅₀; nM). The corresponding activity of the isolated compound is also provided along with the measured mass (ES⁺).

TABLE 1 STRUCTURE ACTIVITY (M + H)⁺

E* 282.1

B* 384.1

C* 430.1

B* 384.1

A 560.2

C 463.2

B* 420.1

A 446.1

B* 450.2

B* 404.1

C* 414.1

D* 560.2

B* 384.1

A 518.2

B* 414.1

D* 608.2

C* 518.2

B 474.2

B* 504.2

B* 414.1

A 504.2

D 428.2

A 504.2

C 370.1

B* 414.1

C* 414.1

A* 432.1

C* 442.2

C* 470.2

A* 418.1

C* 504.2

A 510.0

D* 442.2

A 456.2

C* 330.1

C* 358.1

B* 408.0

B* 356.1

C* 348.1

C* 384.1

B* 348.1

B* 344.1

C* 374.0

C* 314.1

B* 409.1

A* 424.0

D* 362.1

A 434.1

B* 360.1

A 382.1

B* 362.1

B 448.1

A 524.2

B* 394.1

B* 380.1

A 450.1

B* 410.0

B* 398.1

A 379.1

B* 350.1

B* 410.0

A* 382.1

A 421.1

A 474.2

B* 360.1

A* 358.1

A* 382.1

B* 360.1

C* 357.1

B* 480.1

A 513.2

B* 368.1

A 510.2

B* 360.1

A* 346.1

B* 396.1

B* 391.1

B* 332.1

B* 444.2

A* 494.2

B* 510.2

A 382.1

A* 390.1

B* 524.2

A* 449.2

B* 464.1

B* 510.2

A* 535.1

B* 410.0

B* 360.1

B* 350.1

A 718.3

B* 400.1

B* 444.2

B* 414.0

B* 350.1

A 462.2

B* 468.2

B* 430.1

A 364.1

D* 422.1

C* 412.2

B* 432.1

A 457.1

A 600.2

A* 360.1

B* 433.1

C* 362.1

A 482.1

A 438.1

B* 484.2

B 420.1

A* 391.1

B* 442.0

A 420.1

A* 366.0

A 400.2

A 599.2

A 600.2

A 596.2

A 686.2

A 573.2

A 606.2

A 559.2

A 487.2

A 570.2

A 537.2

B 556.2

A 488.2

A 518.2

A 501.2

A 473.2

A 628.3

A 718.3

B 529.2

A 504.2

A 487.2

A 490.1

A 486.2

A 639.2

B 504.2

A 548.2

A 594.2

A 360.1

A 638.2

A 459.2

A 559.2

A 391.1

A 454.0

A 474.2

A 532.0

A 474.2

A 622.1

A 460.1

A 376.1

B 361.1

A 466.1

A 476.1

A 460.1

A 566.2

A 467.1

A 379.0

A 391.1

A 543.1

B 432.1

A 469.1

A 395.0

A 522.2

A 443.1

A 474.2

A 391.1

A 485.1

B 376.1

A 533.2

B 421.1

B 408.1

D* 452.0

A 456

B 436.1

A 576.1

B* 456.0

B* 525.0

B* 546.0

B* 576.1

B* 396.0

A* 456.0

C* 349.0

B* 403.0

B* 452.0

B* 546.0

B* 561.0

A 456.0

B* 393.1

B* 423.0

B* 423.0

B 422.0

D* 529.0

B* 542.1

B* 522.1

C* 589.1

D* 499.1

B* 452.0

C* 441.0

A* 561.0

C* 408.1

B* 393.1

C* 378.0

D* 390.0

B* 576.1

B* 364.0

E* 588.1

A 422.0

B* 525.0

C* 444.1

C* 534.2

B 450.2

A 430.1

A 472.2

B 432.1

A 562.2

B 412.2

A 478.2

B 432.1

A 656.2

D 404.2

A 486.2

B 416.1

A* 522.2

B 536.2

A 446.1

D 444.2

A 398.2

B 536.2

B 460.2

D 598.2

A 494.1

B* 414.1

D 430.1

B 508.2

A 536.2

B 446.1

A 504.2

C* 430.2

A 522.2

B 414.2

A 474.2

B 534.2

D 520.2

A 358.1

D* 414.2

A 520.2

A 487.2

A 486.2

B 574.2

A 530.2

A 560.2

A 514.2

B 514.2

B 604.3

B 550.2

D* 464.1

B* 386.1

D 533.2

A 619.2

D 529.2

A 617.2

B 527.2

C 531.2

A 461.2

B 553.2

A 563.2

A 653.2

A 539.2

B 549.2

D 487.2

A 577.2

B* 428.1

B* 442.2

B* 432.2

B* 446.2

B 541.2

B* 406.0

B* 424.0

A 616.2

B 496.1

B 468.2

C 478.2

D* 331.1

C* 333.1

A 445.1

D* 344.1

E* 424.1

C 396.1

E* 358.1

A 496.1

A 508.2

A 536.2

A 522.2

A 566.2

A 552.2

A 448.12

TABLE 2 STRUCTURE ACTIVITY (M + H)⁺

D* 443.1

E* 443.1

E* 328.0

E* 385.1

E* 385.1

E* 399.1

E* 385.1

D* 442.1

E* 439.1

D* 457.1

D* 441.1

D* 385.1

E* 399.1

D* 453.1

E* 386.0

D* 342.0

E* 435.0

E* 428.1

E* 310.1

B* 460.2

B* 424.1

B* 364.2

C* 420.2

C* 396.1

D* 456.2

D* 392.2

C* 358.1

B  394.1

B* 366.1

B* 414.2

C* 472.2

B* 372.1

D* 403.1

B* 388.1

B* 372.1

B* 358.1

B* 473.2

B* 436.0

B* 401.1

A  376.1

B* 373.1

B* 401.1

B* 416.1

B* 372.1

B* 473.2

B  604.2

C* 426.1

B* 373.1

D* 524.1

A* 424.1

D* 360.1

B* 420.1

B* 372.1

B* 468.2

B* 472.2

C* 432.0

D* 344.1

TABLE 3 STRUCTURE ACTIVITY (M + H)⁺

D* 521.2

C* 503.1

D* 456.1

D* 457.1

D* 485.1

D* 485.1

E* 399.1

D* 463.1

D* 427.1

E* 501.2

D* 456.1

D* 427.1

D* 485.1

D* 485.1

D* 457.1

D* 503.1

D* 463.1

D* 414.1

D  336.1

D  350.1

D  351.1

E* 288.1

E* 316.2

D* 362.2

D* 408.2

D* 344.2

D* 442.1

D* 372.2

D* 334.2

E* 315.2

D* 350.1

D* 394.1

E* 364.2

D* 400.2

D* 341.2

D* 346.2

D* 336.1

D* 358.2

D* 330.2

D* 364.2

D* 361.2

E* 346.2

E* 384.2

E* 350.1

D* 359.2

E* 334.2

E* 334.2

E* 346.2

E* 350.1

E* 384.2

E* 341.2

B* 340.1

C* 352.2

D* 409.1

D* 384.1

D* 491.1

E* 499.2

D* 497.1

E* 548.1

D* 518.1

D* 510.2

E* 499.2

D* 518.1

D* 428.1

D* 441.1

E* 497.1

D* 513.2

D* 484.1

D* 455.1

E* 554.2

D* 428.1

D* 427.1

E* 441.1

D* 497.1

D* 560.2

D* 441.1

D* 498.1

E* 436.1

E* 495.1

E* 510.2

D* 484.2

E* 427.1

E* 344.2

E* 418.1

D* 364.2

D* 418.2

B  576.2

C  456.2

E* 386.3

E* 386.3

D* 384.1

E* 395.1

D* 352.2

E* 418.1

D* 472.0

D* 384.1

D* 352.2

D* 384.1

D* 374.1

E* 358.2

D* 418.1

E* 370.1

B  349.1

B  393.1

C  333.1

B  383.1

B  351.1

C* 347.2

C* 407.1

D* 363.1

D* 363.1

C  377.1

D  391.2

E* 234.1

C* 404.2

C* 422.2

D* 296.1

D* 376.2

E* 282.1

E* 296.1

D* 338.1

E* 324.1

E* 324.1

D  336.1

D* 487.1

TABLE 4 ACTIV- STRUCTURE ITY (M + H)⁺

D* 322.1

E* 322.1

E* 348.2

E* 335.2

D* 408.1

TABLE 5 ABBRE- NAME VIATION STRUCTURE methyl Me —CH₃ ethyl Et —CH₂CH₃ n-propyl nPr —CH₂CH₂CH₃ iso-propyl iPr —CH(CH₃)₂ n-butyl nBu —CH₂CH₂CH₂CH₃ tert-butyl tBu —C(CH₃)₃ sec-butyl —CH(CH₂)(CH₂CH₃) iso-butyl iBu —CH₂CH(CH₃)₂ n-pentyl nPent —CH₂CH₂CH₂CH₂CH₃ 3-pentanyl or pentan-3-yl —CH(CH₂CH₃)₂ amyl —CH₂CH(CH₃)CH₂CH₃ neopentyl —CH₂C(CH₃)₃ 3-methyl-2-butanyl —CH(CH₃)CH(CH₃)₂ tertiary amyl —C(CH₃)₂CH₂CH₃ n-hexyl nHex —CH₂CH₂CH₂CH₂CH₂CH₃ phenyl Ph —C₆H₅ benzyl Bn —CH₂C₆H₅ acetyl Ac —C(═O)CH₃ tert-butyloxycarbonyl Boc —C(═O)OC(CH₃)₃ tert-butyldimethylsilyl TBDMS —Si(Me)₂tBu para-methoxybenzyl PMB —CH₂C₆H₅(4-OMe) Biotin

EQUIVALENTS References

All publications and patents mentioned herein are hereby incorporated by reference in their entirety as if each individual publication or patent was specifically and individually incorporated by reference. In case of conflict, the present application, including any definitions herein, will control.

Equivalents

While specific embodiments of the present disclosure have been discussed, the above specification is illustrative and not restrictive. Many variations of this disclosure will become apparent to those skilled in the art upon review of this specification. The full scope of the disclosure should be determined by reference to the claims, along with their full scope of equivalents, and the specification, along with such variations.

Unless otherwise indicated, all numbers expressing quantities of ingredients, reaction conditions, and so forth used in the specification and claims are to be understood as being modified in all instances by the term “about.” Accordingly, unless indicated to the contrary, the numerical parameters set forth in this specification and attached claims are approximations that may vary depending upon the desired properties sought to be obtained by the present disclosure. 

What is claimed is:
 1. A compound of formula (I):

or a pharmaceutically acceptable form thereof; wherein: R^(A) is selected from C₆₋₁₄ aryl and 5-14 membered heteroaryl; R^(B) is selected from C₆₋₁₄ aryl and 5-14 membered heteroaryl, wherein R^(B) is substituted at least with the group -L-R^(D); R^(C) is selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, with the proviso that R^(C) is not —CH₃; wherein: L is a covalent bond or a divalent C₁₋₁₀ hydrocarbon chain, wherein one, two or three methylene units of L are optionally and independently replaced with one or more —O—, —S—, —NR^(B8)—, —(C═NR^(B8))—, —C(═O)—, —C(═S)—, —S(═O)—, —S(═O)₂—, divalent carbocyclyl, divalent heterocyclyl, divalent aryl or divalent heteroaryl group; R^(D) is selected from N₃, —SO₂H, —SO₃H, —C(═O)R^(B7), —CO₂H, —CHO, —C(OR^(B9))₂, —CO₂R^(B7), —OC(═O)R^(B7), —OCO₂R^(B7), —C(═O)N(R^(B8))₂, —OC(═O)N(R^(B8))₂, —NR^(B8)C(═O)R^(B7), —NR^(B8)CO₂R^(B7), —NR^(B8)C(═O)N(R^(B8))₂, —C(═NR^(B8))OR^(B7), —OC(═NR^(B8))R^(B7), —OC(═NR^(B8))OR^(B7), —C(═NR^(B8))N(R^(B8))₂, —OC(═NR^(B8))N(R^(B8))₂, —NR^(B8)C(NR^(B8))N(R^(B8))₂, —C(═O)NR^(B8)SO₂R^(B7), —NR^(B8)SO₂R^(B7), —SO₂N(R^(B8))₂, —SO₂R^(B7), —SO₂OR^(B7), —OSO₂R^(B7), —S(═O)R^(B7), —OS(═O)R^(B7)—C(═S)N(R^(B8))₂, —C(═O)SR^(B7), —C(═S)SR^(B7), —SC(═S)SR^(B7), —P(═O)₂R^(B7), —OP(═O)₂R^(B7), —P(═O)(R^(B7))₂, —OP(═O)(R^(B7))₂, —OP(═O)(OR^(B9))₂, —P(═O)₂N(R^(B8))₂, —OP(═O)₂N(R^(B8))₂, —P(═O)(NR^(B8))₂, —OP(═O)(NR^(B8))₂, —NR^(B8)P(O)(OR^(B9))₂, NR^(B8)P(═O)(NR^(B8))₂, —B(OR^(B9))₂, —BR^(B7)(OR^(B9)), and tetrazolyl; each instance of R^(B7) is, independently, selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl; each instance of R^(B8) is, independently, selected from hydrogen, —OH, —OR^(B7), —N(R^(B9))₂, —CN, —C(═O)R^(B7), —C(═O)N(R^(B9))₂, —CO₂R^(B7), —SO₂R^(B7), —C(═NR^(B9))OR^(B7), —C(═NR^(B9))N(R^(B9))₂, —SO₂N(R^(B9))₂, —SO₂R^(B9), —SO₂OR^(B9), —SOR^(B7), —C(═S)N(R^(B9))₂, —C(═O)SR^(B9), —C(═S)SR^(B9), —P(═O)₂R^(B7), —P(═O)(R^(B7))₂, —P(═O)₂N(R^(B9))₂, —P(═O)(NR^(B9))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(B8) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring; and each instance of R^(B9) is, independently, selected from hydrogen, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(B9) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring.
 2. The compound of claim 1, wherein L is a covalent bond.
 3. The compound of claim 1, wherein L is a divalent C₁₋₁₀ hydrocarbon chain, wherein one methylene unit of L is optionally and independently replaced with a divalent carbocyclyl, divalent heterocyclyl, divalent aryl or divalent heteroaryl group.
 4. The compound of claim 1, wherein R^(D) is selected from —SO₂H, —SO₃H, —C(═O)R^(B7), —CO₂H, —CHO, —CO₂R^(B7), —C(═O)N(R^(B8))₂, —C(═NR^(B8))OR^(B7), —C(═NR^(B8))N(R^(B8))₂, —C(═O)NR^(B8)SO₂R^(B7), —SO₂N(R^(B8))₂, —SO₂R^(B7), —SO₂OR^(B7), —S(═O)R^(B7), —C(═S)N(R^(B8))₂, —C(═O)SR^(B7), —C(═S)SR^(B7), —P(═O)₂R^(B7), —P(═O)(R^(B7))₂, —P(═O)₂N(R^(B8))₂, —P(═O)(NR^(B8))₂, —B(OR^(B9))₂, —BR^(B7)(OR^(B9)) and tetrazolyl.
 5. The compound of claim 4, wherein R^(D) is selected from —C(═O)R^(B7), —CO₂H, —CHO, —CO₂R^(B7), —C(═O)N(R^(B8))₂, —C(═NR^(B8))OR^(B7), —C(═NR^(B8))N(R^(B8))₂, —C(═O)NR^(B8)SO₂R^(B7), —C(═S)N(R^(B8))₂, —C(═O)SR^(B7) and —C(═S)SR^(B7).
 6. The compound of claim 5, wherein R^(D) is selected from —C(═O)R^(B7), —CO₂H, —CHO, and —CO₂R^(B7).
 7. The compound of claim 6, wherein R^(D) is —CO₂H.
 8. The compound of claim 1, wherein R^(B) is further substituted with the group: —R^(E) wherein: R^(E) is selected from halogen, —OH, —OR^(B10), —ON(R^(B11))₂, —N(R^(B11))₂, —N(OR^(B12))R^(B12), —SH, —SR^(B10), —SSR^(B12), —OC(═O)R^(B10), —OCO₂R^(B10), —OC(═O)N(R^(B11))₂, —NR^(B11)C(═O)R^(B10), —NR^(B11)CO₂R^(B10), —NR^(B11)C(═O)N(R^(B11))₂, —OC(═NR^(B11))R^(B10), —OC(═NR^(B11))OR^(B10), —OC(═NR^(B11))N(R^(B11))₂, —NR^(B11)C(═NR^(B11))N(R^(B11))₂, —NR^(B11)SO₂R^(B10), OSO₂R^(B10), —OS(═O)R^(B10), —Si(R^(B10))₃, —OSi(R^(B10))₃, —SC(S)SR^(B10), —OP(═O)₂R^(B10), —OP(═O)(R^(B10))₂, —OP(═O)(OR^(B12))₂, —OP(═O)₂N(R^(B11))₂, —OP(═O)(NR^(B11))₂, —NR^(B11)P(═O)(OR^(B12))₂, —NR^(B11))₂, —P(R^(B12))₂, —P(R^(B12))₃, —OP(R^(B12))₂, —OP(R^(B12))₃, 3-14 membered heterocyclyl and 5-14 membered heteroaryl, wherein the point of attachment of the 3-14 membered heterocyclyl or 5-14 membered heteroaryl group is on a nitrogen atom; each instance of R^(B10) is, independently, selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl; each instance of R^(B11) is, independently, selected from hydrogen, —OH, —OR^(B10), —N(R^(B12))₂, —CN, —C(═O)R^(B10), —C(═O)N(R^(B12))₂, —CO₂R^(B10), —SO₂R^(B10), —C(═NR^(B12))OR^(B10), —C(═NR^(B12))N(R^(B12))₂, —SO₂N(R^(B12))₂, —SO₂R^(B12), —SO₂OR^(B12), —SOR^(B10), —C(═S)N(R^(B12))₂, —C(═O)SR^(B12), —C(═S)SR^(B12), —P(═O)₂R^(B10), —P(═O)₂(R^(B10))₂, —P(═O)₂N(R^(B12))₂, —P(═O)(NR^(B12))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(B11) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring; and each instance of R^(B12) is, independently, selected from hydrogen, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(B12) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring.
 9. The compound of claim 8, wherein R^(E) is selected from halogen, —OH, —OR^(B10), —ON(R^(B11))₂, —N(R^(B11))₂, —N(OR^(B12))R^(B12), —SH, —SR^(B10), —SSR^(B12), —Si(R^(B10))₃, —OSi(R^(B10))₃, —P(R^(B12))₂, —P(R^(B12))₃, —OP(R^(B12))₂, —OP(R^(B12))₃, 3-14 membered heterocyclyl and 5-14 membered heteroaryl, wherein the point of attachment of the 3-14 membered heterocyclyl or 5-14 membered heteroaryl group is on a nitrogen atom.
 10. The compound of claim 9, wherein R^(E) is selected from halogen, —OR^(B10) and —N(R^(B11))₂.
 11. The compound of claim 1, wherein R^(C) is C₃₋₁₀ alkyl.
 12. The compound of claim 1, wherein R^(C) is C₃₋₁₀ carbocyclyl.
 13. The compound of claim 1, wherein R^(A) is C₆₋₁₄ aryl or 5-14 membered heteroaryl, and R^(B) is C₆₋₁₄ aryl.
 14. The compound of claim 13, wherein R^(A) is C₆₋₁₄ aryl and R^(B) is C₆₋₁₄ aryl.
 15. The compound of claim 13, wherein R^(A) is 5-14 membered heteroaryl and R^(B) is C₆₋₁₄ aryl.
 16. The compound of claim 1, wherein the compound is of the formula (II):

or a pharmaceutically acceptable form thereof; wherein each group W—R¹, W—R², W—R³, W—R⁴, and W—R⁵ independently represents either a nitrogen atom (N) or C—R¹, C—R², C—R³, C—R⁴, or C—R⁵, respectively; and wherein R¹, R², R³, R⁴ and R⁵ are, independently, selected from the group consisting of hydrogen, halogen, —CN, —NO₂, —N₃, —SO₂H, —SO₃H, —OH, —ON(R^(A2))₂, —N(R^(A2))₂, —N(OR^(A3))R^(A3), —SH, —SR^(A1), —SSR^(A3), —C(═O)R^(A1), —CO₂H, —CHO, —C(OR^(A3))₂, —CO₂R^(A1), —OC(═O)R^(A1), —OCO₂R^(A1), —C(═O)N(R^(A2))₂, —OC(═O)N(R^(A2))₂, —NR^(A2)C(═O)R^(A1), —NR^(A2)CO₂R^(A1), —NR^(A2)C(═O)N(R^(A2))₂, —C(═NR^(A2))OR^(A1), —OC(═NR^(A2))R^(A1), —OC(═NR^(A2))OR^(A1), —C(═NR^(A2))N(R^(A2))₂, —OC(═NR^(A2))N(R^(A2))₂, —NR^(A2)C(═NR^(A2))N(R^(A2))₂, —C(═O)NR^(A2)SO₂R^(A1), —NR^(A2)SO₂R^(A1), —SO₂N(R^(A2))₂, —SO₂R^(A1), —SO₂OR^(A1), —OSO₂R^(A1), —S(═O)R^(A1), —OS(═O)R^(A1), —Si(R^(A1))₃, —OSi(R^(A1))₃—C(═S)N(R^(A2))₂, —C(═O)SR^(A1), —C(═S)SR^(A1), —SC(═S)SR^(A1), —P(═O)₂R^(A1), —OP(═O)₂R^(A1), —P(═O)(R^(A1))₂, —OP(═O)(R^(A1))₂, —OP(═O)(OR^(A3))₂, —P(═O)₂N(R^(A2))₂, —OP(═O)₂N(R^(A2))₂, —P(═O)(NR^(A2))₂, —OP(═O)(NR^(A2))₂, —NR^(A2)P(═O)(OR^(A3))₂, —NR^(A2)P(═O)(NR^(A2))₂, —P(R^(A3))₂, —P(R^(A3))₃, —OP(R^(A3))₂, —OP(R^(A3))₃, —B(OR^(A3))₂, or —BR^(A1)(OR^(A3)), C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl; or one or more of R¹ and R², R² and R³, R³ and R⁴ or R⁴ and R⁵ are joined to form a C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl or 5-14 membered heteroaryl ring; each instance of R^(A1) is, independently, selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl; each instance of R^(A2) is, independently, selected from hydrogen, —OH, —OR^(A1), —N(R^(A3))₂, —CN, —C(═O)R^(A1), —C(═O)N(R^(A3))₂, —CO₂R^(A1), —SO₂R^(A1), —C(═NR^(A3))OR^(A1), —C(═NR^(A3))N(R^(A3))₂, —SO₂N(R^(A3))₂, —SO₂R^(A3), —SO₂ORA³, —SOR^(A1), —C(═S)N(R^(A3))₂, —C(═O)SR^(A3), —C(═S)SR^(A3), —P(═O)₂R^(A1), —P(═O)(R^(A1))₂, —P(═O)₂N(R^(A3))₂, —P(═O)(NR^(A3))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(A2) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring; and each instance of R^(A3) is, independently, selected from hydrogen, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(A3) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring; wherein each group W—R⁶, W—R⁷, W—R⁸, W—R⁹, and W—R¹⁰ independently represents either a nitrogen atom (N) or C—R⁶, C—R⁷, C—R⁸, C—R⁹, or C—R¹⁰, respectively; R⁶, R⁷, R⁸, R⁹ and R¹⁰ are, independently, selected from the group consisting of hydrogen, halogen, —CN, —NO₂, —N₃, —SO₂H, —SO₃H, —OH, —OR^(B1), —ON(R^(B2))₂, —N(R^(B2))₂, —N(OR^(B3))R^(B3), —SH, —SR^(B1), —SSR^(B3), —C(═O)R^(B1), —CO₂H, —CHO, —C(OR^(B3))₂, —CO₂R^(B1), —OC(═O)R^(B1), —OCO₂R^(B1), —C(═O)N(R^(B2))₂, —OC(═O)N(R^(B2))₂, —NR^(B2)C(═O)R^(B1), —NR^(B2)CO₂R^(B1), —NR^(B2)C(═O)N(R^(B2))₂, —C(═NR^(B2))OR^(B1), —OC(═NR^(B2))R^(B1), —OC(═NR^(B2))OR^(B1), —C(═NR^(B2))N(R^(B2))₂, —OC(═NR^(B2))N(R^(B2))₂, —NR^(B2)C(═NR^(B2))N(R^(B2))₂, —C(═O)NR^(B2)SO₂R^(B1), —NR^(B2)SO₂R^(B1), —SO₂N(R^(B2))₂, —SO₂R^(B1), —SO₂OR^(B1), —OSO₂R^(B1), —S(═O)R^(B1), —OS(═O)R^(B1), —Si(R^(B1))₃, —OSi(R^(B1))₃—C(═S)N(R^(B2))₂, —C(═O)SR^(B1), —C(═S)SR^(B1), —SC(S)SR^(B1), —P(═O)₂R^(B1), —OP(═O)₂R^(B1), —P(═O)(R^(B1))₂, —OP(═O)(R^(B1))₂, —OP(═O)(OR^(B3))₂, —P(═O)₂N(R^(B2))₂, —OP(═O)₂N(R^(B))₂, —P(═O)(NR^(B2))₂, —OP(═O)(NR^(B2))₂, —NR^(B2)P(═O)(OR^(B3))₂, —NR^(B2)P(═O)(NR^(B2))₂, —P(R^(B3))₂, —P(R^(B3))₃, —OP(R^(B3))₂, —OP(R^(B3))₃, —B(OR^(B3))₂, —BR^(B1)(OR^(B3)), C₁₋₁₀ alkyl, C₁₋₁₀-perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, 5-14 membered heteroaryl, -L-R^(D) and —R^(E); or one or more of R⁶ and R⁷, R⁷ and R⁸, R⁸ and R⁹ or R⁹ and R¹⁰ are joined to form a C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl or 5-14 membered heteroaryl ring; or R¹⁰ and R^(C) are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring; wherein at least one of R⁶, R⁷, R⁸, R⁹, and R¹⁰ is the group -L-R^(D); each instance of R^(B1) is, independently, selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl; each instance of R^(B2) is, independently, selected from hydrogen, —OH, —OR^(B1), —N(R^(B3))₂, —CN, —C(═O)R^(B1), —C(═O)N(R^(B3))₂, —CO₂R^(B1), —SO₂R^(B1), —C(═NR^(B3))OR^(B1), —C(═NR^(B3))N(R^(B3))₂, —SO₂N(R^(B3))₂, —SO₂R^(B3), —SO₂OR^(B3), —SOR^(B1), —C(═S)N(R^(B3))₂, —C(═O)SR^(B3), —C(═S)SR^(B3), —P(═O)₂R^(B1), —P(═O)(R^(B1))₂, —P(═O)₂N(R^(B3))₂, —P(═O)(NR^(B3))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(B2) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring; each instance of R^(B3) is, independently, selected from hydrogen, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(B3) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring; L is a covalent bond or a divalent C₁₋₁₀ hydrocarbon chain, wherein one, two or three methylene units of L are optionally and independently replaced with one or more —O—, —S—, —NR^(B8)-, —(C═NR^(B8))—, —C(═O)—, —C(═S)—, —S(═O)—, —S(═O)₂—, divalent carbocyclyl, divalent heterocyclyl, divalent aryl or divalent heteroaryl group; and wherein R^(D) is selected from —N₃, —SO₂H, —SO₃H, —C(═O)R^(B7), —CO₂H, —CHO, —C(OR^(B9))₂, —CO₂R^(B7), —OC(═O)R^(B7), —OCO₂R^(B7), —C(═O)N(R^(B8))₂, —OC(═O)N(R^(B8))₂, —NR^(B8)C(═O)R^(B7), —NR^(B8)CO₂R^(B7), —NR^(B8)C(═O)N(R^(B8))₂, —C(═NR^(B8))OR^(B7), —OC(═NR^(B8))R^(B7), —OC(═NR^(B8))OR^(B7), —C(═NR^(B8))N(R^(B8))₂, —OC(═NR^(B8))N(R^(B8))₂, —NR^(B8)C(═NR^(B8))N(R^(B8))₂, —C(═O)NR^(B8)SO₂R^(B7), —NR^(B8)SO₂R^(B7), —SO₂N(R^(B8))₂, —SO₂R^(B7), —SO₂OR^(B7), —OSO₂R^(B7), —S(═O)R^(B7), —OS═OR^(B7), —C(═S)N(R^(B8))₂, —C(═O)SR^(B7), —C(═S)SR^(B7), —SC(═S)SR^(B7), —P(═O)₂R^(B7), —OP(═O)₂R^(B7), —P(═O)(R^(B7))₂, —OP(═O)(R^(B7))₂, —OP(═O)(OR^(B9))₂, —P(═O)₂N(R^(B8))₂, —OP(═O)₂N(R^(B8))₂, —P(═O)(NR^(B8))₂, —OP(═O)(NR^(B8))₂, —NR^(B8)P(═O)(OR^(B9))—NR^(B8)P(═O)(NR^(B8))₂, —B(OR^(B9))₂, —BR^(B7)(OR^(B9)) and tetrazolyl; each instance of R^(B7) is, independently, selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl; each instance of R^(B8) is, independently, selected from hydrogen, —OH, —OR^(B7), —N(R^(B9))₂, —CN, —C═OR^(B7), —C(═O)N(R^(B9))₂, —CO₂R^(B7), —SO₂R^(B7), —C(═NR^(B9))OR^(B7), —C(═NR^(B9))N(R^(B9))₂, —SO₂N(R^(B9))₂, —SO₂R^(B9), —SO₂OR^(B9), —SOR^(B7), —C(═S)N(R^(B9))₂, —C(═O)SR^(B9), —C(═S)SR^(B9), —P(═O)₂R^(B7), —P(═O)(R^(B7))₂, —P(═O)₂N(R^(B9))₂, —P(═O)(NR^(B9))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(B8) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring; and each instance of R^(B9) is, independently, selected from hydrogen, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(B9) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring; R^(E) is selected from halogen, —OH, —OR^(B10), —ON(R^(B11))₂, —N(R^(B11)), —N(OR^(B12))R^(B12), —SH, —SR^(B10), —SSR^(B12), —OC(═O)R^(B10), —OCO₂R^(B10), —OC(═O)N(R^(B11))₂, —NR^(B11)C(═O)R^(B10), —NR^(B11)CO₂R^(B10), —NR^(B11)C(═O)N(R^(B11))₂, —OC(═NR^(B11))R^(B10), —OC(═NR^(B11))OR^(B10), —OC(═NR^(B11))N(R^(B11))₂, —NR^(B11)C(═NR^(B11))N(R^(B11))₂, —NR^(B11)SO₂R^(B10), —OSO₂R^(B10), —OS(═O)R^(B10), —Si(R^(B10))₃, —OSi(R^(B10))₃, —SC(S)SR^(B10), —OP(═O)₂R^(B10), —OP(═O)(R^(B10))₂, —OP(═O)(OR^(B12))₂, —OP(═O)₂N(R^(B11))₂, —OP(═O)(NR^(B11))₂, —NR^(B11)P(═O)(OR^(B12))₂, —NR^(B11)P(═O)(NR^(B11))₂, —P(R^(B12))₂, —P(R^(B12))₃, —OP(R^(B12))₂, —OP(R^(B12))₃, 3-14 membered heterocyclyl and 5-14 membered heteroaryl, wherein the point of attachment of the 3-14 membered heterocyclyl or 5-14 membered heteroaryl group is on a nitrogen atom; each instance of R^(B10) is, independently, selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl; each instance of R^(B11) is, independently, selected from hydrogen, —OH, —OR^(B10), —N(R^(B12))₂, —CN, —C(═O)R^(B10), —C(═O)N(R^(B12))₂, —CO₂R^(B10), —SO₂R^(B10), —C(═NR^(B12))OR^(B10), —C(═NR^(B12))N(R^(B12))₂, —SO₂N(R^(B12))₂, —SO₂R^(B12), —SO₂OR^(B12), —SOR^(B10), —C(═S)N(R^(B12))₂, —C(═O)SR^(R12), —C(═S)SR^(B12), —P(═O)₂R^(B10), —P(═O)(R^(B10))₂, —P(═O)₂N(R^(B12))₂, —P(═O)(NR^(B12))₂, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(B11) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring; each instance of R^(B12) is, independently, selected from hydrogen, C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, or two R^(B12) groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring; R^(C) is selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl, with the proviso that R^(C) is not —CH₃.
 17. The compound of claim 16, wherein at least one of R⁶, R⁷, R⁸, R⁹ and R¹⁰ is the group —R^(E).
 18. A pharmaceutical composition comprising a compound of formula (I):

or a pharmaceutically acceptable form thereof, and a pharmaceutically acceptable excipient; wherein: R^(A) is selected from C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl and 5-14 membered heteroaryl; R^(B) is selected from C₁₋₁₀ alkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl and 5-14 membered heteroaryl; R^(C) is selected from C₁₋₁₀ alkyl, C₁₋₁₀ perhaloalkyl, C₂₋₁₀ alkenyl, C₂₋₁₀ alkynyl, 3-14 membered heteroaliphatic, C₃₋₁₀ carbocyclyl, 3-14 membered heterocyclyl, C₆₋₁₄ aryl, and 5-14 membered heteroaryl.
 19. A pharmaceutical composition comprising at least one compound of formula (I) according to claim 1, or a pharmaceutically acceptable form thereof; and at least one pharmaceutically acceptable excipient.
 20. The compound of claim 16, wherein the group of the formula

is a group of formula


21. The compound of claim 20, where the group of formula

is a group of formula


22. The compound of claim 21, wherein one of R¹ and R⁵ is halogen, —CN, —OR^(A1), —N(R^(A2))₂, —CO₂H, —CO₂R^(A1), —C(═O)N(R^(A2))₂, —SO₂R^(A1), C₁₋₁₀ alkyl, C₂₋₁₀ alkynyl, 3-14 membered heterocyclyl, and C₆₋₁₄ aryl, and the other of R¹ and R⁵ is halogen, —CN, —OR^(A1), —N(R^(A2))₂, —CO₂H, —CO₂R^(A1), —C(═O)N(R^(A2))₂, —SO₂R^(A1), C₁₋₁₀ alkyl, C₂₋₁₀ alkynyl, 3-14 membered heterocyclyl, and C₆₋₁₄ aryl.
 23. The compound of claim 22, wherein one of R¹ and R⁵ is halogen, —OR^(A1), C₁₋₁₀ alkyl, or —C(═O)N(R^(A2))₂, and the other of R¹ and R⁵ is halogen, —OR^(A1), C₁₋₁₀ alkyl, or —C(═O)N(R^(A2))₂.
 24. The compound of claim 23, wherein each of R¹ and R⁵) is independently halogen.
 25. The compound of claim 24, wherein each of R¹ and R⁵ is independently selected from fluoro and chloro.
 26. The compound of claim 25, wherein each of R¹ and R³ is independently fluoro.
 27. The compound of claim 1, wherein the compound is:

or a pharmaceutically acceptable form thereof.
 28. The compound of claim 1, wherein the compound is:

or a pharmaceutically acceptable form thereof.
 29. The compound of claim 1, wherein the compound is:

or a pharmaceutically acceptable form thereof.
 30. The compound of claim 1, wherein the compound is:

or a pharmaceutically acceptable form thereof.
 31. The compound of claim 1, wherein the compound is:

or a pharmaceutically acceptable form thereof.
 32. The pharmaceutical composition of claim 19 wherein the compound is:

or a pharmaceutically acceptable form thereof.
 33. The pharmaceutical composition of claim 19, wherein the compound is:

or a pharmaceutically acceptable form thereof.
 34. The pharmaceutical composition of claim 19, wherein the compound is:

or a pharmaceutically acceptable form thereof.
 35. The pharmaceutical composition of claim 19, wherein the compound is:

or a pharmaceutically acceptable form thereof. 